High Cholesterol: The Basics

High blood cholesterol is one of the major risk factors for heart attack, the leading cause of death in America. Cholesterol is a waxy substance your body produces to help it function properly. Because your liver makes all the cholesterol your body needs, you don't need to consume additional cholesterol.

About lipids

Lipids is the scientific name for fatty substances. Cholesterol and triglycerides are two kinds of lipids carried through the blood. In order for cholesterol to move easily throughout the body, it is packaged with a protein. These protein packages are called lipoproteins. Two different kinds of lipoproteins—low density and high density—are used to assess your risk of heart disease.

Low-density lipoproteins

Low-density lipoproteins (LDLs) contain most of the cholesterol in the blood. They carry cholesterol to body tissues, including the coronary arteries. The cholesterol found in LDL is considered most responsible for the formation of plaque, a fatty substance that builds up on the walls of the arteries. The plaque formation eventually can lead to a heart attack or hardening of the arteries. This is why the cholesterol in these particles is often called "bad" cholesterol. High levels of LDL increase the risk of heart disease.

High-density lipoproteins

High-density lipoproteins (HDLs) carry the same form of cholesterol as LDLs. However, the cholesterol in HDLs is not used to form plaques. HDL particles actually pick up cholesterol from other tissues in the body and are believed to be responsible for removing excess cholesterol from your blood. The cholesterol in these packages is called "good" cholesterol, because higher levels of HDL protect against heart disease.

Triglycerides

Triglyceride is another type of fat. Fat is an important source of energy and provides essential nutrients for health. Some of the triglycerides in your body come from the fat you eat. Your body also makes triglycerides when you consume more calories than you need from carbohydrates, proteins, and alcohol. The same lipoproteins that transport cholesterol also move triglycerides to cells where they are needed. High triglycerides are associated with an increased risk for heart disease, especially when HDL levels are low.

Measuring your blood cholesterol

Everyone age 20 or older should have their cholesterol measured at least once every 5 years. A lipoprotein profile will measure your total cholesterol, HDL, LDL, and triglycerides. You need to be fasting for these tests to be accurate.

Cholesterol levels rise with age. Women's LDL levels rise after menopause. High blood cholesterol can run in families. If you have high blood cholesterol, ask other family members if they have had their cholesterol measured.

LDL cholesterol	<100 optimal*	100-129 near optimal/above optimal	130-159 borderline high	160-189 high	>190 very high
HDL cholesterol	<40 low	>60 high
Total cholesterol	<200 desirable	200-239 borderline high	>240 high
Triglycerides	<150 normal	150-199 borderline high	200-499 high	>500 very high

*This is the optimal LDL goal if you have heart disease, diabetes, or multiple risk factors.