High cholesterol is a common genetic condition that can be treated with lifestyle changes and medication. Cholesterol is a fat that's found in all your cells and travels through your blood in small packages made of fat (lipid) and proteins, called lipoproteins. The body needs some cholesterol to stay healthy, but too much of it can cause or contribute to other health issues, such as high blood pressure, heart disease, and strokes. Fortunately, learning about high cholesterol and taking steps to prevent or manage the condition can help you stay healthy.

What Is High Cholesterol?

There are two main types of cholesterol in your blood:

  • Low-density lipoprotein (LDL) or "bad" cholesterol: This type of cholesterol can build up in your artery walls, raising your risk of heart disease and strokes.
  • High-density lipoprotein (HDL) or "good" cholesterol: This type of cholesterol helps remove bad cholesterol from your blood, reducing your risk of heart disease and strokes.

High cholesterol occurs when there's too much bad cholesterol or an unhealthy mix of cholesterol in your blood.

Stages and Types of High Cholesterol

A blood test can help your doctor determine the amount and type of cholesterol in your blood. Your doctor will then check your results against the following guidelines:

Total cholesterol:

  • Desirable: Below 200 mg/dL
  • Borderline high: 200-239 mg/dL
  • High: Above 240 mg/dL

LDL cholesterol:

  • Desirable: 100-129 mg/dL
  • Borderline high: 130-159 mg/dL
  • High: 160-189 mg/dL

HDL cholesterol:

  • Desirable: 60 mg/dL and above
  • Undesirable: Below 40 mg/dL

The amount and type of cholesterol in your blood is important because it helps your doctor decide on the best treatment plan.

Symptoms and Causes

High cholesterol doesn't usually cause any symptoms and can be diagnosed during a blood test that measures your cholesterol levels. If you're age 20 or older and don't have heart disease, your doctor may recommend a cholesterol test every four to six years. If you have heart disease or are at high risk for the condition, you may need more frequent testing.

There's no one single cause of high cholesterol. Factors that can contribute to high cholesterol include inactivity, obesity, cigarette smoking, and an unhealthy diet. Your genetic makeup may also play a part in causing high cholesterol.

Prevention and Risks

Several factors can increase your risk for high cholesterol, including the following:

  • Eating an unhealthy diet
  • Being overweight
  • Having a large waist circumference
  • Not exercising regularly
  • Cigarette smoking
  • Having a medical condition that is known to increase your risk for high cholesterol such as diabetes, kidney disease, or liver disease
  • Having an inherited condition, such as familial hypercholesterolemia, that can cause high cholesterol

Even if you have risk factors for high cholesterol, you can still take steps to prevent the condition. To help prevent high cholesterol:

  • Eat a healthy, balanced diet
  • Maintain a healthy weight
  • Quit smoking
  • Exercise on a regular basis
  • Drink alcohol in moderation, if at all

Diagnosis and Tests

Doctors test your blood to diagnose high cholesterol. A blood test typically reports:

  • LDL cholesterol
  • HDL cholesterol
  • Total cholesterol

You may need to fast for a certain amount of time before your blood test. Be sure to ask your doctor if fasting is necessary.

After your cholesterol test, your doctor will explain your results and suggest any necessary treatment.

Treatment, Procedures, and Medication

If you have high cholesterol, it's important to see your doctor regularly. Any of the following doctors can treat high cholesterol:

  • Primary care physician
  • Cardiologist
  • Endocrinologist

In addition to seeing a doctor, you may wish to consult a dietitian for advice on lowering your cholesterol through your diet, since diet and lifestyle changes are usually the first choice of treatment for high cholesterol. If despite making these changes, your cholesterol levels stay high, your doctor may prescribe medications to lower your cholesterol levels.

Most medications to treat high cholesterol work by:

  • Reducing the amount of bad cholesterol you make
  • Blocking the absorption of cholesterol from the foods that you eat

Common choices of medications include:

  • Statins, such as atorvastatin (Lipitor)
  • Niacin or vitamin B3
  • Cholesterol absorption inhibitors, such as ezetimibe (Zetia)
  • Fibrates, such as gemfibrozil (Lopid)

When high cholesterol occurs as a complication of another medical condition, treating the underlying condition will often help to lower your cholesterol levels.

Healthy Lifestyle Tips

Following a healthy lifestyle can help you lower high cholesterol levels. To reduce your cholesterol levels:

  • Exercise regularly: Exercise helps raise your good cholesterol levels. Aim to get at least two and a half hours of aerobic exercise each week. Brisk walking, bicycling and swimming are examples of aerobic exercise.
  • Quit smoking: If you smoke cigarettes, stop. Quitting smoking might improve your good cholesterol levels.
  • Drink alcohol in moderation: If you drink alcohol, follow the recommended guidelines. These currently stand at one alcoholic drink per day for women and two alcoholic drinks per day for men. Regularly drinking large amounts of alcohol can increase your bad cholesterol levels.

Eating a healthy, balanced diet can also help you prevent or manage high cholesterol. Follow these tips for a healthy diet:

  • Eat more oily fish: Try to eat at least two servings of oily fish, such as salmon or herring, each week.
  • Eat more fiber: Foods high in fiber include fruits, vegetables, legumes, nuts and whole grains.
  • Choose healthier fats: Look for foods that are low in saturated fats, trans fats, and cholesterol.


Preventing or managing high cholesterol may seem like a challenge, but there are steps you can take to keep your cholesterol under control. By following a healthy diet and lifestyle and taking medication if necessary, you can control your cholesterol levels and keep your heart healthy.