Cholesterol Basics

Cholesterol matters, but why?

American Heart Association | Thursday, August 8, 2013
We need some cholesterol to make our bodies function properly, but too much can increase our heart disease risk.

What Is Cholesterol?

It may surprise you to know that cholesterol itself isn't bad. In fact, cholesterol is just one of the many substances created and used by our bodies to keep us healthy. Some of the cholesterol we need is produced naturally (and can be affected by your family health history), while some of it comes from the food we eat.

There are two types of cholesterol: "good" and "bad." It's important to understand the difference, and to know the levels of "good" and "bad" cholesterol in your blood. Too much of one type—or not enough of another—can put you at risk for coronary heart disease, heart attack or stroke.

Cholesterol comes from two sources: your body and food. Your liver and other cells in your body make about 75 percent of blood cholesterol. The other 25 percent comes from the foods you eat. Cholesterol is only found in animal products.

A cholesterol screening measures your level of HDL and LDL. HDL is the "good" cholesterol which helps keep the LDL (bad) cholesterol from getting lodged into your artery walls. A healthy level of HDL may also protect against heart attack and stroke, while low levels of HDL (less than 40 mg/dL for men and less than 50 mg/dL for women) have been shown to increase the risk of heart disease.

If you need to increase your HDL to your reach your goals, studies show that regular physical activity, such as at least 150 minutes of moderate-intensity aerobic physical activity (e.g. brisk walking) every week or 75 minutes of vigorous intensity aerobic physical activity (e.g., jogging, running) or a combination of both every week can help your body produce more HDLs. Reducing trans fats and eating a balanced, nutritious diet is another way to increase HDL. If you smoke—stop: cigarette smoking can decrease your HDL. If these measures are not enough to increase your HDL to goal, your health-care practitioner may prescribe a medication specifically to increase your HDLs.

LDL cholesterol is the "bad" cholesterol. When too much of it circulates in the blood, it can clog arteries, increasing your risk of heart attack and stroke.

LDL cholesterol is produced naturally by the body, but many people inherit genes from their mother, father or even grandparents that cause them to make too much. Eating saturated fat, trans fats and dietary cholesterol also increases how much you have. If high blood cholesterol runs in your family, lifestyle modifications may not be enough to help lower your LDL blood cholesterol. Everyone is different, so work with your doctor to find a treatment plan that's best for you.

Why Cholesterol Matters

High cholesterol is one of the major controllable risk factors for coronary heart disease, heart attack and stroke. As your blood cholesterol rises, so does your risk of coronary heart disease. If you have other risk factors (such as high blood pressure or diabetes) as well as high cholesterol, this risk increases even more. The more risk factors you have, the greater your chance of developing coronary heart disease. Also, the greater the level of each risk factor, the more that factor affects your overall risk.

When too much LDL cholesterol circulates in the blood, it can slowly build up in the inner walls of the arteries that feed the heart and brain. Together with other substances, it can form plaque, a thick, hard deposit that can narrow the arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, a heart attack or stroke can result.

High blood cholesterol: As blood cholesterol rises, so does risk of coronary heart disease. When other risk factors (such as high blood pressure and tobacco smoke) are present, this risk increases even more. Your cholesterol level can be affected by your age, gender, family health history and diet.

Understanding Your Risk

LDL cholesterol is produced naturally by the body, but many people inherit genes from their mother, father or even grandparents that cause them to make too much. Eating saturated fat, trans fats and dietary cholesterol also increases how much you have. If high blood cholesterol runs in your family, lifestyle modifications may not be enough to help lower your LDL blood cholesterol. Everyone is different, so work with your doctor to find a treatment plan that's best for you.

Symptoms

Even though high cholesterol may lead to serious heart disease, most of the time there are no symptoms. This is why it is important to have your cholesterol levels checked by your doctor.

To reduce your risk of heart disease and stroke, work with your health-care professionals to monitor and maintain healthy cholesterol levels. Even if your cholesterol levels are good now, it's not too early to develop healthy habits that can help keep your numbers in check.

Prevention and Treatment

Too much cholesterol in the blood can lead to cardiovascular disease. Cardiovascular disease is the No. 1 cause of death in the United States. 2,200 Americans die of cardiovascular disease each day, an average of one death every 39 seconds. The good news is, you can lower your cholesterol and reduce your risk of heart disease and stroke. Take responsibility for managing your cholesterol levels. Whether you've been prescribed medication or advised to make diet and lifestyle changes to help manage your cholesterol, carefully follow your doctor's recommendations.

Lifestyle Changes

Your diet, weight, physical activity and exposure to tobacco smoke all affect your cholesterol level—and these factors may be controlled by:

  • eating a heart-healthy diet,
  • enjoying at least 150 minutes a week moderate-intensity aerobic physical activity, and more than two days a week muscle strengthening activities, and
  • avoiding tobacco smoke.

Drug Therapy Options

For some people, lifestyle changes alone aren't enough to reach healthy cholesterol levels. Your doctor may prescribe medication. Learn about:

Work With Your Doctor

It takes a team to develop and maintain a successful health program. You and your health-care professionals each play an important role in maintaining and improving your heart health. Know how to talk with your doctor about your cholesterol levels and be sure you understand all instructions. Follow your plan carefully, especially when it comes to medication—it won't work if you don't take it as directed. And learn how to make diet and lifestyle changes easy and lasting.