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Understanding High Cholesterol: A Comprehensive Guide

What is high cholesterol? How can you get your cholesterol tested? What do your cholesterol numbers mean? Get the answers to these and more questions about managing your cholesterol levels.

Cholesterol Levels: The Importance of Getting Tested

High cholesterol is a significant health concern in the United States. From 2017 to 2020, 86.4 million U.S. adults aged 20 or older had high or borderline high cholesterol levels, defined as a total cholesterol level greater than or equal to 200 mg/dL. Additionally, about 1 in 5 adolescents had an unhealthy cholesterol measurement during the period from 2009 to 2016. The problem with high cholesterol is that it often goes unnoticed, as it does not typically present any symptoms. The only way to know if you have high cholesterol is to get a blood test, also known as a lipid profile, to measure your cholesterol levels.

Who Needs to Get Their Cholesterol Checked?

Many people have never had their cholesterol checked, so they are unaware of their risk. It is recommended that cholesterol be checked starting at an early age, even in children and adolescents. Most healthy adults should have their cholesterol checked every 4 to 6 years. However, some people, such as those with heart disease, diabetes, or a family history of high cholesterol, may need to get their cholesterol checked more frequently. Children and adolescents should have their cholesterol checked at least once between ages 9 and 11 and again between ages 17 and 21. Children who have obesity or diabetes may need to be screened for high cholesterol more often.

Understanding the Cholesterol Test

The cholesterol test, or screening, requires a simple blood draw. The test checks your levels of various types of cholesterol, including:

  • Low-density lipoprotein (LDL) or “bad” cholesterol, which can lead to plaque buildup in your arteries and increase your risk of heart disease and stroke.
  • High-density lipoprotein (HDL) or “good” cholesterol, which can lower your risk of heart disease and stroke.
  • Triglycerides, a type of fat in your blood that your body uses for energy. High levels of triglycerides combined with low HDL or high LDL can increase your risk of heart attack and stroke.
  • Total cholesterol, which is the overall amount of cholesterol in your blood based on your HDL, LDL, and triglycerides numbers.

You may need to fast (not eat or drink) for 8 to 12 hours before your cholesterol test, so be sure to ask your doctor how to prepare for the test.

Interpreting Your Cholesterol Numbers

Your cholesterol numbers are important, but they are just one part of your overall health. Your health care team will look at your cholesterol numbers, along with your family history, age, sex, and other factors that could increase your risk for high cholesterol, such as smoking. They may also order a coronary artery calcium (CAC) scan to help understand your risk and determine the best way to manage your cholesterol levels. This complete picture helps your health care team determine whether you should take steps, such as lifestyle changes or cholesterol-lowering medication, to lower your risk for heart disease and stroke.

Optimal Cholesterol Levels

What are the optimal blood cholesterol levels? The 2018 ACC/AHA Guidelines recommend that cholesterol management be based on a person’s lifetime cardiovascular risk, whether a person is 45 to 75 years of age, has diabetes, and has other factors. Your health care team will work with you to determine your optimal cholesterol levels and the best approach to managing your cholesterol.

Monitoring and Managing High Cholesterol

If your cholesterol levels are high, your health care team may recommend lifestyle changes, such as a healthy diet and regular exercise, to help lower your cholesterol. In some cases, they may also prescribe cholesterol-lowering medications. Regularly monitoring your cholesterol levels and working with your health care team to manage your cholesterol is essential for maintaining your overall heart health.

Conclusion

High cholesterol is a common health issue, but it can often be managed through a combination of lifestyle changes and medical treatment. Getting your cholesterol checked regularly and working with your health care team to interpret your results and develop a plan to manage your cholesterol levels is crucial for reducing your risk of heart disease and stroke. By understanding your cholesterol numbers and taking the necessary steps to maintain healthy levels, you can improve your overall cardiovascular health.