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Your Guide to Lowering High Cholesterol

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Cholesterol and Your Heart Health

Medically Reviewed By William C. Lloyd III, MD, FACS
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Many people think of cholesterol as “bad,” but it’s actually essential for many normal body functions. It’s high cholesterol that’s the problem, especially when it comes to heart health. If you have high cholesterol, you are more at risk for developing conditions that affect your heart, which can lead to heart attack or stroke. Fortunately, you can take steps to prevent or lower high cholesterol. Your doctor can help you make a plan for tackling high cholesterol with lifestyle changes and, if necessary, medications.

Understanding Cholesterol and Heart Health

Cholesterol is a waxy substance your body naturally produces in your liver. You also absorb cholesterol by eating foods that come from animal sources. Cholesterol circulates in your blood, reaching cells throughout your body to assist them in several vital functions, such as making cell membranes, producing vitamin D, and synthesizing many of the hormones used throughout the body.

There are two types of cholesterol: the “good” kind known as high-density lipoprotein (HDL) cholesterol, and the “bad” kind known as low-density lipoprotein (LDL) cholesterol. HDL cholesterol actually helps protect your body against heart attack and stroke, but too much LDL cholesterol can increase your risk for these conditions.

Triglycerides, the most common type of fat inside your body, also play a role in your cholesterol levels and high levels may also be linked to heart disease. Many people with high LDL cholesterol also have high triglycerides; in many cases, this is caused by other medical conditions such as diabetes, liver disease, or hypothyroidism. Triglycerides also play a role in how your total cholesterol level is calculated. Total cholesterol is calculated using your HDL, LDL, and triglyceride levels and should be no more than 200 milligrams per deciliter (mg/dl).

High Cholesterol Dangers

When doctors talk about high cholesterol, they’re often referring to high levels of LDL cholesterol in your body. If you have excess LDL cholesterol, it may combine with other substances to form fatty buildups called plaques on the inside of your arteries. This condition, called atherosclerosis, is a type of heart disease that makes arteries less flexible and more narrow, preventing blood from flowing properly. Eventually, blood flow to the heart muscle slows significantly and can even become blocked. This is problematic because your blood carries oxygen to your heart–if the blood flow slows, your heart won’t get enough oxygen and you may experience chest pain. If the blood flow completely stops, you can have a heart attack. Additionally, in some cases, portions of a plaque can break off from the artery wall, and may cause serious issues like stroke.

HDL cholesterol helps eliminate LDL cholesterol by carrying it back to your liver from your arteries, where it’s broken down and eventually flushed out of your body. However, HDL cholesterol won’t get rid of all LDL cholesterol—in fact, it only helps remove one-fourth to one-third of the LDL cholesterol you have. Lowering high cholesterol often involves a combination of diet, exercise, healthy lifestyle choices, and, for some people, medications.

Lowering High Cholesterol

Your doctor can easily check your cholesterol using a simple blood test. The latest research indicates that your LDL cholesterol should be below 70 mg/dl if you’re at high risk for cardiovascular disease. If you’re relatively healthy, your LDL level should be below 100 mg/dl.

To help you achieve those numbers, your doctor may recommend a few lifestyle changes such as:

  • Eating a heart-healthy diet
  • Getting more exercise
  • Losing weight
  • Quitting smoking

For some, it may also be necessary to begin taking medications specifically designed to help lower cholesterol levels. Several different types of medications, including prescription statins, bile acid sequestrants, fibrates, and omega-3 fatty acids may all help keep your numbers in check. Your doctor may recommend a cholesterol medication if lifestyle changes alone aren’t enough to improve your cholesterol levels. Some people have hereditary high cholesterol that can be more challenging to lower, but medications like newer PCSK9 inhibitors can make a significant impact in these cases.

Cholesterol is necessary for many vital functions in your body, but too much cholesterol can place you at risk for serious medical issues, particularly those that involve your heart. Knowing your cholesterol numbers can help you determine whether you’re at risk—and if you are, your doctor can help you decide on a plan of action to lower your cholesterol and stay as healthy as possible.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Feb 26
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