What is High Cholesterol? A Guide to Understanding It

High cholesterol means having too much of a waxy substance in your blood. This substance is needed to build healthy cells. But too much can up your heart disease risk.1 It causes fatty deposits in your blood vessels. Such build-up can block blood flow. This situation can lead to heart attack and stroke. Lifestyle choices play a big role in high cholesterol. Yet, sometimes it runs in families too. You can lower it by eating well, exercising, and taking medicine.

Key Takeaways

  • High cholesterol is a serious condition that can increase your risk of heart disease, heart attack, and stroke.
  • Cholesterol is a waxy substance found in your blood, and your body needs it to build healthy cells.
  • High levels of cholesterol can lead to the development of fatty deposits in your blood vessels, making it difficult for enough blood to flow through your arteries.
  • High cholesterol can be caused by unhealthy lifestyle choices or inherited factors.
  • Adopting a healthy diet, regular exercise, and sometimes medication can help reduce high cholesterol and lower your risk of heart disease.

Understanding Cholesterol

Cholesterol is a waxy, fat-like substance found in your blood. Your body needs cholesterol to build healthy cells. Too much of it, however, can be harmful. There are two types: LDL and HDL.

What is Cholesterol?

LDL is “bad” because it can build up in your arteries, forming plaques. HDL is “good” since it helps remove extra cholesterol from your body.2

Types of Cholesterol

Your cholesterol levels are checked with a lipid panel blood test. This test shows your total cholesterol, LDL, HDL, and triglycerides.2

How is Cholesterol Measured?

Your health provider uses the test to see if your cholesterol is in a healthy range. Depending on your results, you might need to change your lifestyle or take medicine.2


Normal Cholesterol Levels

Keeping your cholesterol levels in check is key for heart health. Aim for a total cholesterol level below 200 mg/dL. Your LDL (bad) cholesterol should be under 100 mg/dL. Also, your HDL (good) cholesterol needs to be above 60 mg/dL.1 Remember, these goals might change based on age and gender.

Healthy Cholesterol Ranges

If you were assigned female at birth, you should have a higher HDL level than those assigned male (at least 50 mg/dL for you, 40 mg/dL for them).1 For children and teens, the first cholesterol check should happen between 9 and 11. Then, tests should be done every five years.1 Your doctor can help you set cholesterol targets just right for you.

Factors Affecting Normal Levels

Your cholesterol levels can be influenced by lifestyle and genetics. Keep an eye on your diet, exercise habits, weight, and family history.3 Conditions like diabetes or hypothyroidism can mess with these levels too.3 Knowing what factors play a role is the first step to keeping your health in check.

Normal Cholesterol Levels

High Cholesterol Levels

Having high cholesterol often means your total is 200 mg/dL or more.1 Doctors might also say “borderline high” or “near optimal” for different levels. It’s important to know what high cholesterol is to tackle it.

What Constitutes High Cholesterol?

A normal total cholesterol for adults is under 200 mg/dL.4 Between 200 and 239 mg/dL is borderline high. 240 mg/dL or more is high.4 The ideal amount of LDL (bad) cholesterol is under 100 mg/dL. This is especially true for those with diabetes or heart problems.4 LDL levels between 130 and 159 mg/dL are borderline high. High LDL is 160 to 189 mg/dL.4

Risk Factors for High Cholesterol

Eating a lot of saturated and trans fats, not exercising, being obese, smoking, and drinking too much can cause high cholesterol.1 Other factors include diabetes, underactive thyroid, and a family history of cholesterol issues.1 Not being active, being overweight, and eating poorly can mess with your cholesterol and triglycerides.5 If your BMI is 30 or more, you’re also at risk.5 It’s key to spot and deal with these risks to fight high cholesterol.

what is high cholesterol

High cholesterol means there’s too much cholesterol in the blood. This causes plaque to build up in the arteries. The arteries become narrow and hard, which is dangerous.5 Having high cholesterol increases the risk of heart disease, heart attack, and stroke.5 It often comes from eating poorly, not exercising enough, being overweight, or from some health conditions or medications.5 Since it doesn’t show symptoms, a blood test is needed to catch it.5 You can usually lower it by changing what you eat and sometimes by taking medicine.

The National Heart, Lung, and Blood Institute (NHLBI) says to check cholesterol by ages 9 to 11, then every 5 years.5 If you’re a man between 45 and 65, or a woman between 55 and 65, test every 1 to 2 years. After 65, it’s best to test every year.5 High cholesterol risks include bad diet, obesity, little exercise, smoking, too much drinking, and getting older.5

Health issues like chronic kidney disease, diabetes, HIV/AIDS, hypothyroidism, and lupus can all mess with your cholesterol.5 Also, some medicines, even those for acne or cancer, can make cholesterol levels worse.5

If your total cholesterol is 200 mg/dL or more, that’s usually high.1 Females need higher HDL levels than males. Children and teens should start testing between 9 to 11, then every 5 years.1 How often adults check cholesterol changes depending on sex and age.1

In the U.S., about 1 in 3 adults has high blood pressure and high cholesterol.6 Sadly, treating these conditions isn’t always successful.6 For kids and teens, cholesterol checks should start at 9, then happen every 5 years.6

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Things like smoking, stress, too much alcohol, not moving enough, and bad eating lead to high cholesterol.6 Smoking is especially risky for heart and blood vessel health.6 Chronic kidney disease (CKD) can cause higher triglycerides and VLDL cholesterol.6

high cholesterol

In dealing with high cholesterol, what you do every day is just as vital as any medicine.6

Causes of High Cholesterol

Many things can lead to high cholesterol. It’s important to know these causes to manage it well.

Lifestyle Factors

Our daily choices greatly affect our cholesterol. Eating a lot of saturated and trans fats, not moving much, carrying extra weight, and drinking too much can spike your cholesterol.5 Not being active, carrying extra weight, and eating poorly boost cholesterol and triglycerides.5 Bad eating habits, obesity, little exercise, smoking, too much alcohol, and being over 40 also raise cholesterol.5

Medical Conditions

Certain health issues can spike cholesterol too. Conditions like chronic kidney disease, diabetes, HIV/AIDS, low thyroid function, and lupus are big culprits.5 Cholesterol may start climbing in childhood due to lifestyle and genetic reasons.6


Even some medicines can push your cholesterol up. This includes drugs for acne, cancer, high blood pressure, and managing HIV/AIDS.5

Complications of High Cholesterol

High cholesterol, if not treated, can cause big health troubles. The main issue is atherosclerosis.5 This is when plaques build up in the arteries. It makes the arteries narrower and harder. This slows down blood flow and oxygen to organs.5


Atherosclerosis can cause heart problems. It can lead to heart disease and raise the risk of a heart attack.5 The condition also affects the carotid arteries, increasing the chance of a stroke.5 These issues can be deadly if not managed well. It shows how important it is to control cholesterol with better living habits and sometimes, medicine.5

Coronary Artery Disease

Plaque buildup in the heart’s arteries due to high cholesterol can slow blood flow. This causes coronary artery disease.5 With this disease, the heart may not get enough oxygen and nutrients. This raises the risk of a heart attack.5


High cholesterol can harm the carotid arteries that supply the brain with blood and oxygen.5 Atherosclerosis can make these arteries narrow and hard. This raises the chance of a stroke. Strokes lower oxygen to the brain, which is life-threatening.5

If you don’t treat high cholesterol, the outcomes can be severe. This shows why we must try hard to lower cholesterol. It helps to avoid heart disease, heart attacks, and strokes.56

Diagnosing High Cholesterol

High cholesterol gets diagnosed with a simple blood test. This test is called a lipid panel or lipid profile. It checks your total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides.7 The National Heart, Lung, and Blood Institute (NHLBI) says people should get their cholesterol checked first between 9 and 11 years old. After that, every 5 years is enough.6

Cholesterol Screening Guidelines

If you’re a man between 45 and 65, or a woman between 55 and 65, you should get screened every 1-2 years. Once you hit 65, it’s best to do it every year.6 Your doctor might want you to test more often if your cholesterol levels aren’t good.

Managing High Cholesterol

Managing high cholesterol begins with diet changes. Cut back on saturated and trans fats8. Eat more fruits, veggies, whole grains, and lean meats.8 Doing this, along with at least 30 minutes of daily exercise, improves HDL and lowers LDL levels.9

Dietary Changes

Eating a heart-healthy diet is key. Avoid saturated fats mostly in red meat and full-fat dairy.8 Stay away from trans fats in margarines and baked goods too.8 Opt for more fruits, veggies, grains, and lean meats. Foods rich in soluble fiber, like oatmeal and Brussels sprouts, can also help.8

Exercise and Physical Activity

Physical activity is vital. Aim for 150 minutes of weekly moderate exercise to lower cholesterol and blood pressure.9 This could be brisk walking, swimming, or cycling. It helps increase HDL cholesterol, giving extra heart benefits.8


Sometimes, diet and exercise aren’t enough. Your doctor may suggest cholesterol-lowering drugs.10 These can include statins and other types of medication. Even kids over 10 might get these if their cholesterol is very high.10

Working with your healthcare team is key. They’ll help you make a plan to manage your cholesterol.9 Using diet, exercise, and maybe medicine, you can make a big difference in your health.

Preventing High Cholesterol

Adopting a healthy lifestyle is crucial for keeping cholesterol low.5 This means eating a diet with few saturated and trans fats, being physically active, and keeping a healthy weight. It’s also about using alcohol in moderation and not smoking.5

Eating lots of fruits, vegetables, whole grains, and proteins that are lean can balance your cholesterol levels.9 Besides, doing 150 minutes of exercise that makes you sweat every week can increase your good cholesterol.9 These steps can lower your risk of high cholesterol and the problems it brings.

Healthy Lifestyle Habits

Taking care of your diet, avoiding being lazy, keeping the right weight, not smoking, and drinking too much can make your cholesterol go up.5 So, it’s key to eat less unhealthy fats and more good foods like fruits and veggies.9

Doing half an hour of exercise that gets you moving most days helps too.9 Also, not smoking and not drinking too much can keep your heart healthy.8

Focusing on health in your food and exercise habits can keep your cholesterol in check.5 This all-around method to dealing with cholesterol, by changing how you eat, moving more, and managing your weight can make your heart stronger.9

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Inherited High Cholesterol Conditions

High cholesterol can sometimes be passed down in families. This is called familial hypercholesterolemia (FH). It happens due to a gene change. This change makes it hard for the body to get rid of LDL (bad) cholesterol.11 Because of this, people with FH might have very high cholesterol levels, even when they’re young.12

This type of high cholesterol makes a person more likely to get heart disease early in life. They need to closely work with doctors. Treatment often includes drugs to lower the cholesterol and lessen the chance of heart problems.

Familial Hypercholesterolemia

FH is more common in people from certain backgrounds. These include French Canadian, Ashkenazi Jewish, Lebanese, or Afrikaner groups.11 Shockingly, over 90% of those with FH don’t know they have it.11 Early diagnosis is critical because FH can lead to heart attacks or strokes, especially in those under 55 years old.11

In serious cases, a treatment called LDL apheresis might be used. This is true when a person gets the gene from both parents.11 If a parent has FH, there is a 50% chance their child will too. If both parents have it, the child will surely inherit it.11

Thankfully, statin medications can be very effective, often cutting LDL levels by half.11 It’s crucial to find high cholesterol early. This can help lower the risk of heart issues. Understanding FH and its treatments lets people take steps to better care for their hearts in the long run.

High Cholesterol in Children and Adolescents

High cholesterol can happen to children and adolescents, not just adults. It’s important for kids to get their cholesterol checked between 9 and 11 years old. Then they should have these tests every 5 years.13 Things that make cholesterol go up in young people are bad eating habits, not moving enough,13 being overweight, and sometimes genes.13 If not dealt with, high cholesterol in the young can grow into heart-harming problems later in life.13 Doctors might suggest changes in how they live or, sometimes, medicine to help keep their hearts strong.

14 High triglyceride levels boost the chances of heart problems.14 Kids and teens with high cholesterol have a bigger risk for heart issues when they’re grown.14 If your family has a history of early heart problems or high cholesterol, keep an eye on these cholesterol numbers: Total Cholesterol should be under 170 mg/dL, close to 200 mg/dL is a bit high, and above 200 mg/dL is high; For the bad cholesterol (LDL), under 110 mg/dL is good, between 110 and 129 mg/dL is starting to be a concern, and over 130 mg/dL is high.14 If you’re 2 to 8 years old and have other heart risk factors, you might need your cholesterol checked.14 Between 9 and 11, it’s a good time for these tests, whether you’ve eaten or not.14 Testing lipids is common between 17 and 21 years old because they settle down after puberty.14 For most kids, the right cholesterol levels include less than 130 mg/dL for LDL and over 60 mg/dL for HDL.14 If LDL is too high, it can block blood vessels and cause heart issues.14 To lower LDL, kids should not eat too much saturated fat, sugar, or junk foods, and they should exercise and keep a healthy weight.14 HDL helps clean up bad cholesterol in our blood, lowering heart disease risk. For a higher HDL, kids should move more, eat less saturated fat, and stay at a healthy weight.

15 Between 9 and 11 years, your child should have their cholesterol level looked at. This is according to the National Heart, Lung, and Blood Institute.15 Their targets for cholesterol levels are: LDL less than 110 mg/dL, HDL over 45 mg/dL, total cholesterol under 170 mg/dL, and triglycerides under 75 for kids up to 9, and under 90 for older kids.15 Some children might need medicine if their cholesterol stays really high, even with eating well for six months. Medicine like statins can help lessen the heart disease risk.15 Things that up a kid’s chances of high cholesterol are already having family history of high cholesterol, heart issues, or certain health problems, obesity, smoking, and bad habits.15 If a child’s cholesterol test comes back bad, they might need more tests like for diabetes and liver health.15 Kids 5 and up should be moving for at least an hour daily for a healthy heart and lower cholesterol.15 Good food includes a lot of fiber, found in whole grains, and little fat. Choose plants over sugary drinks, high fat snacks, and red meat for the healthiest heart.15 What kids eat and how much they move is really key in managing their cholesterol. Encouraging a balanced lifestyle helps their hearts stay strong.

Myths and Misconceptions

High cholesterol is a big deal for health, but many myths make it hard to understand. One big myth is that it only matters for older adults.16 But it can affect anyone, even kids. It’s important to tackle it early to avoid heart problems.

People think high cholesterol always shows clear signs.17 But usually, it doesn’t. The only way to know is through a blood test. This means you might think you’re fine when you’re not.

There’s also the belief that you can “cure” high cholesterol. But you can only manage it with changes in how you live and medication.17 It’s a lifelong thing. Yet, you can keep it under control and lower the chances of health issues.

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Tackling these myths is key in helping people deal with high cholesterol. Clearing up what’s true helps us take action. We learn to watch our cholesterol, live healthier, and get the right care.

Living with High Cholesterol

Living with high cholesterol is tough. But the good news is, you can take steps to manage it. These steps also reduce your risk of health issues.6 Things like smoking, stress, not being active, and what you eat can lead to high cholesterol.6 It’s vital to handle stress well. Stress can make us choose unhealthy habits that make cholesterol worse.

Managing Stress

Trying out regular exercise, meditation, and talking to friends can really help with stress.6 Making key lifestyle changes is also important. This means cutting out bad fats, lessening fried foods, and quitting smoking. Doing this can get high cholesterol and blood pressure under control.

Support and Resources

There’s lots of help out there for managing high cholesterol. The American Heart Association and the National Heart Institute offer great tips.6 They help with treatment and how to live healthier. It’s recommended to start checking cholesterol early, especially if heart issues run in your family.

Looking at the big picture can really improve your heart health.6 Shockingly, many Americans with high cholesterol and blood pressure don’t get the help they need. This means they might not be treating it effectively, if at all.

6 High cholesterol leads to plaque in the arteries. This can cause atherosclerosis in places like the heart, neck, and legs. It raises the risk of heart attacks, strokes, and PAD.6 In the U.S., CAD is a top killer and affects all ages. People with kidney disease are more likely to have heart issues because of poor lipid health and more artery blockage.


High cholesterol is serious and can be bad if you don’t treat it.18 It leads to heart problems and is a top reason for death globally. In the US alone, over 80 million adults deal with cardiovascular diseases.18 More than 100 million Americans have high cholesterol, with 34 million needing treatment.18 So, it’s key to know about cholesterol types, what makes it high, and the risks.

Living healthy can keep your cholesterol in check.19 Eat less saturated fat and cholesterol to lower bad cholesterol.19 Also, move for 30 minutes every day. This could be walking, running, or swimming. It helps make your cholesterol better.19

If you have high cholesterol, work with your doctor on a treatment plan.18 They might suggest medicines. The first choice is often statins.18 Your goal is to keep your cholesterol at a good level. With the right steps, you can manage cholesterol and have a happy, healthy life.


What is high cholesterol?

High cholesterol means you have too much of a waxy substance in your blood. Your body needs it, but too much raises heart disease risk.

What are the different types of cholesterol?

Cholesterol types include LDL, the “bad” kind that can block arteries. HDL is “good” and removes extra cholesterol.

How is cholesterol measured?

A lipid panel tests your blood for total cholesterol, LDL, HDL, and triglycerides.

What are normal cholesterol levels?

Ideal levels depend on age and gender. Generally, below 200 mg/dL total, under 100 mg/dL for LDL, and above 60 mg/dL for HDL is healthy.

What constitutes high cholesterol?

Having over 200 mg/dL of total cholesterol is high. But there are other categories like “borderline high.”

What are the risk factors for high cholesterol?

Unhealthy eating, lack of exercise, and obesity raise your risk. Smoking, too much alcohol, and certain diseases or a family history affect it.

What causes high cholesterol?

Eating badly, not moving enough, and being overweight can cause it. So can some medical conditions and certain medications.

What are the complications of high cholesterol?

If atherosclerosis forms from high cholesterol, it can block blood flow. This can lead to heart attacks or strokes.

How is high cholesterol diagnosed?

A lipid panel blood test detects high cholesterol. It’s first done between 9 and 11 years old, then every 5 years.

How can high cholesterol be managed?

To control it, eat better, move more, and maybe take medicine. Focus on less bad fats, more fruits and veggies, and regular exercise.

How can high cholesterol be prevented?

Start with a good diet, lots of physical activity, and staying a healthy weight. Also cut back on alcohol and quit smoking.

Can high cholesterol be inherited?

Yes, sometimes it’s passed down in families, called FH. It happens when your body can’t clear LDL well.

Can children and adolescents have high cholesterol?

Kids and teens can get high cholesterol. Bad eating, not moving, and genes can make them prone to it.

What are some common myths and misconceptions about high cholesterol?

Common myths say it’s not a worry for younger people or you’ll feel symptoms. Knowing the truth is key to dealing with high cholesterol right.

How can individuals living with high cholesterol manage stress?

Stress affects cholesterol, so managing it is crucial. Doing things like exercise, meditation, and leaning on friends can help.

Source Links

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  7. https://my.clevelandclinic.org/health/diseases/21656-hyperlipidemia
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  9. https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia
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  12. https://www.heart.org/en/health-topics/cholesterol/genetic-conditions/familial-hypercholesterolemia-fh
  13. https://medlineplus.gov/highcholesterolinchildrenandteens.html
  14. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=p01593
  15. https://www.mountsinai.org/health-library/diseases-conditions/high-cholesterol-children
  16. https://www.heart.org/en/health-topics/cholesterol/about-cholesterol/common-misconceptions-about-cholesterol
  17. https://communityhealth.mayoclinic.org/featured-stories/cholesterol-myths
  18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106545/
  19. https://www.stlukeshealth.org/resources/what-is-cholesterol-what-you-need-to-know-2022