High Cholesterol

Cholesterol is a waxy, fat-like substance found in all the cells of your body. Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs, but it is also found in foods from animal sources, such as egg yolks, meat, and cheese.

While the body needs cholesterol to build healthy cells, having high cholesterol can significantly raise the risk of heart disease. When you have too much cholesterol in your blood, it can combine with other substances to form plaque. Plaque sticks to the walls of your arteries, a buildup known as atherosclerosis. This can lead to coronary artery disease, where your arteries become narrowed or even blocked, restricting blood flow to the heart and other organs.

The Role of Cholesterol in the Body

Cholesterol travels through the blood on proteins called lipoproteins. It performs several vital functions:

• Building and maintaining cell membranes.

• Assisting in the production of bile, which is necessary for digestion.

• Serving as a precursor for the production of hormones like estrogen, testosterone, and cortisol.

• Helping the body produce Vitamin D.

What is High Cholesterol?

High cholesterol, also known as hyperlipidemia or hypercholesterolemia, is a condition where you have an excess of lipids (fats) in your blood. Your body needs a balanced amount of lipids to function; however, when there are too many, your body cannot utilize them all. The extra lipids begin to accumulate in your arteries, forming fatty deposits called plaque.

The danger of untreated high cholesterol lies in its "silent" nature. Plaque can grow for years without causing symptoms until a vessel is significantly blocked or a piece of plaque ruptures, causing a blood clot that leads to a heart attack or stroke. A blood test, called a lipid panel, is the only way to identify this buildup before it causes a cardiovascular event.

Symptoms of High Cholesterol

High cholesterol symptoms are famously non-existent. There are typically no physical signs that a person has high cholesterol levels. Because you cannot feel it, many people are unaware their levels are high until they experience a medical emergency like a heart attack or stroke.

When to see a doctor is a critical question. Because high cholesterol has no symptoms, you must rely on a cholesterol test. If you have a family history of heart disease or other risk factors like smoking or diabetes, you should be proactive in requesting a screening rather than waiting for physical signs that may never come.

Causes of High Cholesterol

Several factors contribute to the development of high cholesterol. While some are related to genetics, many are the result of lifestyle choices:

• Smoking and tobacco use: Smoking lowers your "good cholesterol" (HDL) and raises your "bad cholesterol" (LDL). It also damages the lining of the arteries, making it easier for plaque to stick.

• Being under a lot of stress: Stress triggers hormonal changes, such as increased cortisol, which can cause your body to produce more cholesterol.

• Drinking alcohol: Too much alcohol in your body can raise your total cholesterol and triglyceride levels.

• Not moving around enough: Physical activity like aerobic exercise improves your cholesterol numbers. If you have a desk job or sit a lot in your free time, your body won't produce enough "good cholesterol."

• Diet: Consuming too much saturated fat or trans fats leads to unhealthy cholesterol levels. Saturated fats are found in fatty cuts of meat and full-fat dairy, while trans fats are often found in packaged snacks or fried foods.

Risk Factors for High Cholesterol

Certain factors can increase your risk of developing high cholesterol:

• Poor Diet: Eating animal fats and processed treats.

• Obesity: Having a body mass index (BMI) of 30 or higher.

• Age: As you age, your liver becomes less able to remove LDL cholesterol.

• Diabetes: High blood sugar contributes to higher levels of a dangerous cholesterol called very-low-density lipoprotein (VLDL) and lower HDL cholesterol.

• Genetics: Familial hypercholesterolemia is an inherited condition that causes high LDL levels starting from birth.

Normal cholesterol levels by age chart

Maintaining normal cholesterol levels is vital for cardiovascular health. These levels are measured in milligrams per deciliter (mg/dL). For children and adolescents age 19 or younger, a healthy total cholesterol level is less than 170 mg/dL, with LDL (bad) cholesterol below 100 mg/dL and HDL (good) cholesterol above 45 mg/dL.

For adults aged 20 or older, the desirable range for total cholesterol is between 125 and 200 mg/dL. Within this group, LDL cholesterol should ideally remain below 100 mg/dL. HDL levels should be 40 mg/dL or higher for men and 50 mg/dL or higher for women to provide adequate cardiovascular protection.

High cholesterol levels by age chart

Understanding when your numbers indicate a health risk is essential for prevention. Total cholesterol is considered borderline high when it falls between 200 and 239 mg/dL, and it is classified as high once it reaches 240 mg/dL or above.

When looking specifically at LDL cholesterol, levels between 130 and 159 mg/dL are borderline high. An LDL reading of 160 to 189 mg/dL is considered high, and any measurement of 190 mg/dL or above is categorized as very high. These elevated levels significantly increase the risk of plaque accumulation in the blood vessels.

Diagnosing High Cholesterol

A healthcare provider diagnoses high cholesterol using a blood test called a lipid panel. This test measures the fats in your blood to determine your risk of heart disease.

When to Get Your Cholesterol Checked

Current medical guidelines recommend different frequencies based on age and risk factors:

• Children and Teens: Get your cholesterol checked once between ages 9 and 11, and again between 17 and 21. A child whose parents have high cholesterol may begin even sooner.

• Males: Get your cholesterol checked every five years until age 45. From age 45 to 65, get checked every one to two years. After age 65, get checked every year.

• Females: Get checked every five years until age 55. From age 55 to 65, get checked every one to two years. After age 65, get checked every year.

Understanding Your Cholesterol Test Results

Your test results will provide a snapshot of your cardiovascular risk. It is important to look at the full lipid profile rather than just the total number. What is considered high cholesterol depends on your age, sex, and history of heart disease. For example, an LDL level that is acceptable for a healthy 25-year-old might be considered dangerously high for someone with a history of heart attack.

What Do The Numbers Mean?

• LDL (Low-Density Lipoprotein): This is the "bad" cholesterol that makes plaque form in your arteries. Having too many LDLs can lead to heart disease over time.

• HDL (High-Density Lipoprotein): This is the "good" cholesterol. It carries cholesterol to your liver, which then gets rid of it. You must have enough HDLs to keep your blood vessels clear.

• Triglycerides: A type of fat in the blood. High levels often go hand-in-hand with high LDL and low HDL.

Complications of High Cholesterol

Over time, high cholesterol leads to plaque buildup inside your blood vessels, a process called atherosclerosis. This creates a ripple effect across the cardiovascular system.

• Coronary Artery Disease (CAD): This happens when atherosclerosis affects the arteries carrying blood to your heart. It can lead to a heart attack or heart failure. CAD is the leading cause of death in the U.S., and roughly 1 in 5 people who die from it are under age 65.

• Carotid Artery Disease: When plaque narrows the arteries carrying blood to the front of your brain, it can lead to a stroke or a "mini-stroke" (TIA).

• Peripheral Artery Disease (PAD): This affects the arteries in your legs or arms. A key symptom is intermittent claudication—leg cramps that start when moving but stop at rest.

• High Blood Pressure: Cholesterol plaque causes arteries to become hard and narrow. Your heart has to strain much harder to pump blood, resulting in hypertension.

How to Lower Cholesterol

Talk with your healthcare provider about the best way to lower cholesterol. Some people only need simple lifestyle changes, while others require medication.

• Dietary Changes: Eat less saturated fat and trans fat. Fast food, fried foods, and processed snacks should be limited. Focus on fiber-rich foods like oats and vegetables.

• Exercise: Aerobic exercise improves your HDL levels and helps the liver process lipids.

• Medication: Sometimes lifestyle changes aren't enough because your liver produces most of your cholesterol. In these cases, statins or other medical interventions are used to fill the gaps.

• Manage Related Conditions: Treating underlying issues like thyroid disease or diabetes can also help stabilize your lipid levels.

Preventing High Cholesterol

Cholesterol prevention starts with taking control of your lifestyle before plaque has a chance to form.

• Healthy Eating: Prioritize lean proteins and unsaturated fats. Read labels to monitor sodium and hidden trans fats.

• Tobacco Cessation: Stopping smoking is one of the most effective ways to raise your HDL levels quickly.

• Weight Management: Maintaining a healthy weight reduces the strain on your cardiovascular system.

• Regular Check-ups and Screening: The earlier you catch rising levels, the easier they are to manage without intensive medication.

High Cholesterol in Children and Adolescents

High cholesterol isn't just an adult problem; it can start in childhood, which is why early screenings are becoming a standard part of pediatric care.

When Should Children Be Screened?

The American Heart Association recommends that children get checked for high cholesterol once between ages 9 and 11. Screening may start earlier if there is a family history of heart attack or stroke, or if the child has conditions like obesity or diabetes.

Risk Factors for High Cholesterol in Children

Risk factors for high cholesterol in children include a diet high in processed foods, a lack of physical activity, and genetic predisposition. Children with Type 1 or Type 2 diabetes are also at a significantly higher risk for early-onset atherosclerosis.

At Medical Park, we prioritize early detection and personalized treatment plans to ensure your heart stays healthy at every stage of life. Adults looking to manage their lipid profiles in accordance with their particular needs can find comprehensive multidisciplinary care from expert specialists within our Cardiology, Endocrinology, Internal Medicine, and Nephrology departments. For younger patients, our Pediatric Cardiology specialists provide early intervention and screening tailored to growing bodies. In cases where high cholesterol has led to significant arterial blockages, our Cardiovascular Surgery department offers advanced surgical solutions to restore vital blood flow and protect your health.