High cholesterol can be caused by diet, smoking, and genetics. Since it rarely shows symptoms, getting regular cholesterol checks is crucial if you’re at risk.
The Centers for Disease Control and Prevention (CDC) states that nearly 86 million U.S. adults aged 20 or older have cholesterol levels above 200 mg/dL. A total cholesterol level over 240 mg/dL is considered high.
But because high cholesterol (also called hyperlipidemia or dyslipidemia) usually doesn’t cause symptoms, you might not know you have it until you get tested.
What Is Cholesterol?
Cholesterol is a waxy, fat-like substance (a type of lipid) produced by your liver. It’s essential for forming:
- Cell membranes
- Certain hormones
- Vitamin D
Since cholesterol doesn’t dissolve in water, it can’t travel through your blood alone. Your liver produces lipoproteins (particles made of fat and protein) to carry cholesterol and another lipid called triglycerides through your bloodstream.
The two main types of lipoproteins are:
- Low-density lipoprotein (LDL) – “Bad” cholesterol
- High-density lipoprotein (HDL) – “Good” cholesterol
LDL cholesterol is carried by low-density lipoproteins. Too much LDL in your blood can lead to high LDL cholesterol.
Symptoms of High Cholesterol
High cholesterol is usually a “silent” condition with no obvious symptoms. Many people don’t realize they have it until serious complications like heart attack or stroke occur. That’s why regular cholesterol checks are so important.
If you’re 20 or older, ask your doctor about routine cholesterol screenings.
Living with diabetes? Check out our top resources.
Causes and Risk Factors of High Cholesterol
Eating too many foods high in cholesterol, saturated fats, and trans fats can increase your risk of high cholesterol. Obesity, inactivity, and smoking also play a role.
Genetics can affect your chances too. In rare cases, familial hypercholesterolemia (an inherited disorder) prevents the body from removing LDL. Most adults with this condition have:
- Total cholesterol above 240 mg/dL
- LDL levels above 190 mg/dL
Other health conditions like diabetes and hypothyroidism can also raise your risk.
High cholesterol can affect anyone, regardless of age, sex, or ethnicity. While some risk factors can’t be changed, there are ways to lower your risk.
LDL vs. HDL vs. Triglycerides
Here’s how these three types differ:
LDL (“Bad” Cholesterol)
LDL carries cholesterol to your arteries. If levels are too high, plaque can build up in artery walls (atherosclerosis), which can:
- Narrow arteries
- Reduce blood flow
- Increase blood clot risk
A clot blocking an artery in the heart or brain can cause a heart attack or stroke. High cholesterol can also disrupt bile balance, raising the risk of gallstones.
Complications of Atherosclerosis
Atherosclerosis can lead to serious conditions like:
- Stroke
- Heart attack
- Chest pain (angina)
- High blood pressure
- Peripheral vascular disease
- Chronic kidney disease
Learn more about how high cholesterol affects your body.
HDL (“Good” Cholesterol)
HDL helps remove LDL by returning it to the liver, preventing plaque buildup. It lowers the risk of:
- Blood clots
- Heart disease
- Stroke
Triglycerides
Triglycerides are another lipid your body uses for energy. Extra calories are stored as triglycerides in fat cells and transported via lipoproteins.
If you regularly eat more calories than you burn, triglyceride levels can rise, increasing the risk of heart disease and stroke.
A blood test can measure your cholesterol and triglyceride levels.
Cholesterol Testing
The CDC recommends cholesterol checks every 4 to 6 years. If you have a family history or other heart disease risks, your doctor may suggest more frequent tests.
A lipid panel measures:
- Total cholesterol (LDL + HDL)
- LDL cholesterol
- HDL cholesterol
- Triglycerides
If your total or LDL cholesterol is too high, you may be diagnosed with high cholesterol, especially if LDL is high and HDL is low.
Need help finding a doctor? Try our FindCare tool.
Optimal Cholesterol Levels
According to the CDC, most adults should aim for:
| Cholesterol Level | Type |
|---|---|
| ~150 mg/dL | Total |
| ~100 mg/dL | LDL |
| ≥40 mg/dL (men), ≥50 mg/dL (women) | HDL |
| <150 mg/dL | Triglycerides |
StatPearls also categorizes LDL levels:
| LDL Level | Category |
|---|---|
| <100 mg/dL | Optimal |
| 100-129 mg/dL | Near/Above Optimal |
| 130-159 mg/dL | Borderline High |
| 160-189 mg/dL | High |
| ≥190 mg/dL | Very High |
These are general guidelines—your doctor will consider other factors before recommending treatment.
How to Lower Cholesterol
If you have high cholesterol, your doctor may suggest lifestyle changes or medications.
Diet Changes
To improve cholesterol levels:
- Limit foods high in cholesterol, saturated fats, and trans fats.
- Choose lean proteins (chicken, fish, legumes).
- Eat more fiber (fruits, vegetables, whole grains).
- Opt for baked, grilled, or steamed foods.
- Avoid sugary, processed foods.
Foods to limit:
- Red meat, organ meats, egg yolks, high-fat dairy
- Ultra-processed foods with cocoa butter or palm oil
- Fried foods
- Some baked goods (cookies, muffins)
Omega-3 fatty acids (found in fish) may help lower LDL.
Medications
If lifestyle changes aren’t enough, your doctor may prescribe:
- Statins (block cholesterol production) – Lipitor, Crestor, Zocor
- Niacin
- Bile acid resins – Welchol, Colestid, Prevalite
- Cholesterol absorption inhibitors – Zetia
- PCSK9 inhibitors – Praluent, Repatha
Some medications combine treatments, like Vytorin (ezetimibe + simvastatin).
Learn more about cholesterol medications.
Home Remedies
Some people manage cholesterol with:
- A healthy diet & exercise
- Quitting smoking
Certain supplements are also claimed to help (though more research is needed):
- Garlic, hawthorn, astragalus
- Red yeast rice, plant sterols
- Psyllium husk, flaxseed
Always check with your doctor before trying supplements—they can interact with medications.
How to Prevent High Cholesterol
While you can’t change genetics, you can lower risk by:
- Eating a low-cholesterol, high-fiber diet
- Limiting alcohol
- Maintaining a healthy weight
- Exercising regularly
- Avoiding smoking
- Getting routine cholesterol checks
The Takeaway
High cholesterol often has no symptoms but can lead to serious health problems. A doctor can help manage it.
If you’re over 20, consider getting tested. A healthy lifestyle—good diet, exercise, and avoiding smoking—can keep your cholesterol in check.