High Cholesterol: Assessing Your Risk

Have you been told that your cholesterol is too high? If so, you could be heading for a heart attack, also known as acute myocardial infarction (AMI), or stroke. This is especially true if you have other risk factors for heart disease. Get smart about cholesterol and your heart disease risk. This sheet can help you understand your heart disease risk and how your cholesterol level affects it. Talk to your healthcare provider about how to get started controlling your cholesterol.

Why is high cholesterol a problem?

Blood cholesterol is a fatty substance. The body uses it to make membranes in cells and for hormone production. It travels through the bloodstream and is used by the tissues for normal function. When blood cholesterol is high, it forms plaque and causes inflammation. The plaque builds up in the walls of arteries (blood vessels that carry blood from the heart to the body). This narrows the opening for blood flow. Over time, the heart may not get enough oxygen. This can lead to coronary artery disease, heart attack, or stroke.

3 steps to assessing your risk

Step 1. Find your risk factors for heart disease and stroke

How your cholesterol numbers affect your heart health depends on other risk factors for heart attack and stroke. Check off each risk factor below that applies to you:

• Are you a man 45 years old or older or a woman 55 years old or older?

• Does your family have a history of heart problems before the age of 55 in male relatives or age 65 in female relatives? This includes heart attack, coronary heart disease, or atherosclerosis.

• Do you have high blood pressure? Do you take medicine to treat high blood pressure?

• Do you smoke?

• Do you have diabetes?

• Do you exercise very little or not very often? Recommendations are for 30 minutes of exercise at least 5 days a week. If you are not doing cardiovascular exercise as often as these recommendations, it may not be enough and you may be at higher risk for elevated cholesterol and heart disease.

• Do you eat a diet that is high in saturated or trans fats, cholesterol, sugar, or alcohol? You may be at increased risk for heart disease if you do not eat enough fruits, vegetables, lean meats and eat sugars or drink alcohol sparingly.

• Have you been told you have high cholesterol? Do you take medicine to control your cholesterol?

Step 2. Test your cholesterol

Have your cholesterol tested every 5 years after the age of 20 and more often if you have risk factors. Cholesterol testing most often needs no preparation. Sometimes you may be asked to fast (not eat) before your test. A blood sample is taken and sent to a lab. There, the amount of cholesterol and triglyceride in your blood is measured. There are 2 types of cholesterol in the sample. The first is HDL (“good cholesterol”). The second is LDL (“bad cholesterol”). Cholesterol test results are most often shown as the total of HDL and LDL cholesterol numbers. You may also be told the separate HDL and LDL cholesterol results.

Step 3. Discuss the results with your healthcare provider 

If your cholesterol levels are higher than normal, your healthcare provider will help you with steps to take to lower your levels. Steps may include lifestyle changes like diet, physical activity, and quitting smoking, and medicine to lower bad cholesterol levels.

If you have high cholesterol, you may need your cholesterol level tested more often to make sure your medicine and lifestyle changes are working to reduce your risks of having a heart attack or stroke.