What Types Of Cholesterol Are There
There are two different types of cholesterol including:
- “Bad Cholesterol” which carry cholesterol particles throughout your body. LDL cholesterol is bad because it builds up in the walls of your arteries, making them hard and narrow which can increase the risk of a heart attack.
- “Good Cholesterol” which picks up excess cholesterol and takes it back to the liver. Having high HDL is linked to lower risk of heart disease, heart attack, and stroke.
Taking Time To Stay Active
If a person is not at a moderate weight or has obesity, they may have an increased risk of high LDL cholesterol. If a person is not very active and has a high body mass index , they may need to increase their activity levels.
Adults should aim to complete 150 minutes of physical activity a week. A weekly routine may include 30 minutes of exercise over 5 days. A person could try cardio, for example, such as brisk walking or running. Muscle-strengthening activities such as hill walking or resistance weight training may also help with maintaining moderate weight levels.
What Is A Healthy Cholesterol Level
This table is a general guide for ideal cholesterol and triglyceride levels for healthy adults in the UK. If you have a condition such as heart disease or diabetes, your target levels may be lower your doctor will be able to tell you your individual targets.
| Above 6 is considered high risk – the lower this figure is the better | Above 6 is considered high risk – the lower this figure is the better |
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How Are Cholesterol Tests Results Used
Your doctor will make a treatment recommendation based on your level of heart disease risk. Guidelines do not use a single cholesterol level to determine treatment options.
- If you already have coronary heart disease with symptoms such as chest pain or a previous heart attack, taking medication to reduce your low density lipoprotein cholesterol is very beneficial and possibly life-saving.
- If you have been hospitalized due to heart attack or stroke, you will start treatment before you leave the hospital. The latest 2018 cholesterol guidelines recommend using a high-intensity statin , such as higher doses of rosuvastatin or atorvastatin to get cholesterol levels below 70 mg/dL. You will be encouraged to follow a heart-healthy diet, exercise, lose weight and stop smoking, if needed.
- If you do not have a diagnosis of heart disease but your cholesterol levels are high, your doctor will look at your other risk factors, and may determine your 10-year risk of cardiac disease. Usually, lifestyle changes like a healthy diet and exercise are implemented for the first 6 to 12 months. Diet and exercise can drop cholesterol levels by roughly 10 percent.
Cholesterol And Heart Disease: Understanding The Connection
For years, it had been believed that theres more or less a straight line between cholesterol and heart disease but recent research suggests that this relationship may be more complex.
A Minneapolis Heart Foundation study, published in April 2017 in the Journal of the American Heart Association, found that many people who have heart attacks donthave high cholesterol. The link between cholesterol and heart disease is weak, says Dr. Roberts, who places a large portion of the blame for the persistence of that link on pharmaceutical advertising for statin drugs. Statins dolower cholesterol levels, she says, but atherosclerosis still progresses due to factors like age, poor diet, smoking, and so on.
In addition, a review of studies of cholesterol and cardiovascular disease published in August 2015 in the American Journal of Clinical Nutrition found that no rigorous connection could be drawn between dietary cholesterol intake and the risk of CVD.
In contrast, the results of long-term research, published in September 2017 in the journal Circulation, concluded that statin use in men with high LDL cholesterol who had no other risk factors for heart disease reduced their rates of coronary heart disease death, cardiovascular death, and all-cause mortality by 28 percent over 20 years.
Furthermore, a study of more than 400,000 people published in December 2019 in The Lancet found a strong link between non-HDL cholesterol and long-term risk of cardiovascular disease.
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Can High Cholesterol Be Prevented Or Avoided
Making healthy food choices and exercising are two ways to reduce your risk of developing high cholesterol.
Eat fewer foods with saturated fats . Choose healthier fats. This includes lean meats, avocados, nuts, and low-fat dairy items. Avoid foods that contain trans fat . Look for foods that are rich in omega-3 fatty acids. These foods include salmon, herring, walnuts, and almonds. Some egg brands contain omega-3.
Exercise can be simple. Go for a walk. Take a yoga class. Ride your bike to work. You could even participate in a team sport. Aim to get 30 minutes of activity every day.
Dietary Tips To Avoid Cholesterol
The most important thing you can do to reduce your cholesterol level is to maintain a healthy lifestyle. You should try to:
- Increase the amount and variety of fresh fruit, vegetables and wholegrain foods you have each day.
- Choose low or reduced-fat milk, yoghurt and other dairy products or have added calcium soy drinks.
- Choose lean meat .
- Limit fatty meats, including sausages and salami, and choose leaner sandwich meats like turkey breast or cooked lean chicken.
- Have fish at least twice a week.
- Replace butter and dairy blends with polyunsaturated margarines.
- Include foods in your diet that are rich in soluble fibre and healthy fats, such as nuts, legumes and seeds.
- Limit cheese and ice cream to twice a week.
Other storage fats that are transported in blood lipoproteins include triglycerides. When present in high concentrations in the blood, this fat is also a risk for heart attack. Some foods will affect the cholesterol level or the triglyceride level and some will affect both.
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Effects Of High Cholesterol Levels
The liver is the main processing centre for cholesterol and dietary fat. When we eat animal fats, the liver transports the fat, together with cholesterol in the form of lipoproteins, into our bloodstream.
Too much cholesterol circulating within LDL in our bloodstream leads to fatty deposits developing in the arteries. This causes the vessels to narrow and they can eventually become blocked. This can lead to heart disease and stroke.
Good Cholesterol Numbershdl Is Your Friend
When you hear someone talking about good cholesterol, they are referring to HDL, or high density lipoprotein. Lipoproteins are simply complexes that carry fat around the body. HDLs job is to go around the body looking for bad cholesterol, or LDL which we will get to shortly. Once it finds LDL, it removes it from the bloodstream and brings it to the liver to be processed.
So HDLs job is to clear out the LDL. So think of HDL as Batman and LDL is the Joker, the Riddler, the Penguin and all of their cronies. Every day your bodys supply of HDL is fighting the LDL in an ongoing battle for cardiovascular health.
So when people talk about good cholesterol numbers, they mean the amount of HDL in your bloodstream. So what is the ideal amount of HDL? Anything over 60 mg/dL is considered good. In general, it should be over 40 for men, and over 50 for women. Anything less than that is considered a risk for heart disease.
Now lets take a look at HDLs arch enemy
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What Affects Cholesterol Levels
There are a variety of factors that can affect cholesterol levels. Some risk factors are within your control, while others are not:
- Genetics: These factors include familial hypercholesterolemia and a family history of heart disease.
- Sex: Males often have higher levels of LDL. After menopause, a woman’s LDL levels can also increase.
- Weight: People who are overweight or obese are at increased risk of having high cholesterol.
- Sedentary lifestyle: Lack of physical activity can increase the risk of overweight and obesity and, in turn, increase cholesterol levels.
- Diet: Overall diet quality can affect cholesterol in a negative way, including eating too many saturated and trans fats and not enough fiber.
- Age: Your body’s ability to clear cholesterol can be impacted as you age.
- Race and ethnicity: There are different rates of high cholesterol based on race/ethnicity and sex, with the highest rates among males in Hispanics and the highest rates among females in non-Hispanic Whites.
- Smoking: Smoking can increase your bad cholesterol and lower your good cholesterol.
- Other medical conditions: Having a previous history of high cholesterol, heart disease, or diabetes can increase your risk of developing high cholesterol.
When Should You Contact Your Healthcare Provider About Your Cholesterol Levels
In truth, your healthcare provider will probably talk to you about your numbers first. As always, contact your provider if you have any new or worsening pain or other uncomfortable feelings. Make sure you know what medications you take and what they are expected to do. Call the provider if you have a reaction to the medicine.
Before you go to the office, and after you have had a cholesterol test, it helps to have a list of questions prepared about your test results and any proposed treatment.
A note from Cleveland Clinic
When considering cholesterol numbers, its important to remember that you really have the ability to make those numbers go in your favor. What you choose to eat, how much you are able to move and how you deal with lifes ups and downs are things that you can influence.
Last reviewed by a Cleveland Clinic medical professional on 07/31/2020.
References
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How To Lower High Ldl Cholesterol
Your doctor will set up a plan of lifestyle changes and/or medication that can lower your cholesterol levels and your overall odds of a heart problem. Your plan might include:
- A healthy diet. Try not to eat things that are high in saturated fat, cholesterol, or simple carbs such as sugar and white flour. Eat more fiber and plant sterols such as margarine or nuts.
- Regular exercise. The kind that gets your heart pumping is best.
- Weight loss. Losing even 5 to 10 pounds can improve your cholesterol levels.
- Quitting tobacco. If you have a hard time giving up smoking, your doctor can help you find the program thatâs best for you.
- Medication. Some drugs, like statins, help keep your body from making cholesterol. Another, ezetimibe , lowers the amount of cholesterol your body gets from food you eat. If you canât take statins or have a severe form of high cholesterol, you might get shots of PCSK9 inhibitors. These meds help your liver remove more LDL from your blood.
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What Do Your Cholesterol Results Mean
When you have a cholesterol test, it is really important that your healthcare professional explains the results to you to prevent unnecessary worry and confusion.
Its not just your total cholesterol thats important and your results will include different types of cholesterol. If you are only given your total cholesterol, ask for a break-down of the other numbers. Its possible to have a healthy total cholesterol number but an unhealthy balance of the different types of cholesterol.
As a minimum, you should be given your total cholesterol and HDL numbers, then you can work out your ratio of total cholesterol to HDL cholesterol .
You might also have your triglycerides tested, these are another type of blood fat which are linked to heart disease.
Ask for a print out of your results if you are not able to speak to your GP, nurse or pharmacist.
Your results should include:
- Total cholesterol
This is sometimes written as serum cholesterol or TC and refers to your overall level of cholesterol.
- Non-HDL cholesterol
Your non-HDL cholesterol is your total cholesterol minus your HDL cholesterol. Its all the bad cholesterol added together, including your LDL cholesterol. Ideally it should be as low as possible.
- HDL cholesterol
- TC:HDL ratio
You might be given a TC:HDL ratio, which is the ratio of HDL compared to the total cholesterol. If not, you can work it out from your HDL and total cholesterol numbers. This should be as low as possible. Above 6 is considered high.
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Normal Cholesterol Levels By Age
Cholesterol is a waxy, fat-like substance that plays many roles in the body, including synthesizing hormones and vitamin D. It also assists in the transporting of lipids. Cholesterol is found in the foods you eat, but it is also made by the liver.
We need some cholesterol to build healthy cells, but an accumulation of the bad kind can be problematic, increasing the risk of atherosclerosis. The recommended ranges for your cholesterol will depend on your age. Find out what cholesterol levels are, why age is a factor, and how to keep your levels within a healthy range.
Verywell / Jessica Olah
What Is High Cholesterol
Cholesterol is a waxy substance that is made by the liver and obtained through the diet. It can be found in the fats in your blood. High cholesterol is when you have high amounts of cholesterol in the blood.
Cholesterol is essential in order for your body to continue building healthy cells, however having high cholesterol can increase your risk of heart disease. This is because it can lead to a build-up of fatty deposits in your blood vessels, which overtime can make it difficult for enough blood to flow through your arteries and consequently to your heart.
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Getting Help For Your Child
If you are worried about your child’s weight, consider consulting with a registered dietitian or expressing your concerns with your pediatrician.
Children can benefit from getting involved in meal planning, shopping, and cooking, reducing intake of sweetened beverages, and learning how to eat more fruits and vegetables. Being a good role model and getting the entire family on board is also important for making changes and providing your child with confidence.
What Is Total Cholesterol
When your cholesterol is checked, you get a number for total cholesterol, one for the HDL level, and one for the LDL level. Your total cholesterol will be more than the sum of the HDL and LDL numbers.
Either a high HDL number or a high LDL number can make your total cholesterol number high. If it’s high because of a high HDL number, your health is not necessarily in danger. However, if it’s high because your LDL cholesterol level is high, it’s important to talk with your doctor about your health .
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Are There Ways To Manage High Cholesterol Levels
Yes, there are ways to manage high cholesterol levels, including the following:
If your cholesterol is high, it will take time and effort to improve your cholesterol levels and cholesterol ratio. You should count on at least three months of lifestyle changes and possibly taking daily medication. The results, though — a healthier heart and lower risk of heart attack or stroke — are well worth the effort.
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Diet And Lifestyle Changes
A doctor will look at your overall risk of cardiovascular disease and make recommendations to reduce high blood cholesterol as well as managing other risk factors such as high blood pressure, smoking and being overweight.
Reducing high blood cholesterol levels typically involves decreasing the total cholesterol level by decreasing LDL-cholesterol and triglycerides, while maintaining or increasing HDL-cholesterol levels.
- LDL-cholesterol levels are best decreased by eating less saturated fat
- Triglyceride levels are best reduced by eating less sugar-containing foods, limiting alcohol intake, and reducing the intake of total fat
- HDL-cholesterol levels are best increased by exercise, substituting saturated fats with polyunsaturated or monounsaturated fat , and maintaining a healthy weight.
Heart-healthy dietary changes are summarised in our Heart disease diet page.
Other lifestyle changes should include:
- Exercising regularly
- Maintaining a healthy body weight
- Limiting alcohol intake
Heart-healthy exercise suggestions are summarised in our Heart disease exercise page.
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Medications To Lower High Cholesterol
The goal of cholesterol treatment is to help you prevent a heart attack or stroke. So the drugs your doctor prescribes also depend on your chances for heart disease.
The higher your risk, the more important it is to get your levels down. Your doctor will look at all of your risk factors and decide which medications will help you the most.
Cholesterol-lowering drugs include:
Cholesterol-lowering drugs work best when combined with a low-cholesterol diet and an exercise program.
Statins
Statins block the production of cholesterol in the liver. They lower LDL and triglycerides and can slightly raise HDL. These drugs are the first treatment for most people with high cholesterol. If you already have heart disease, statins reduce the chances of heart attacks. Side effects can include diabetes, liver damage, and, in a few people, muscle tenderness or weakness. If your doctor prescribes statins, you should ask them the percentage by which you should lower your cholesterol. Generally, it will be between 30% and 50%. Commonly used statins include:
Niacin
Bile acid sequestrants
These drugs work inside the intestine, where they bind to bile and prevent your circulatory system from reabsorbing it. Bile is made largely from cholesterol, so these drugs work by reducing the body’s supply of cholesterol. That then lowers both total and LDL cholesterol. The most common side effects are constipation, gas, and upset stomach. Commonly used bile acid sequestrants include: