High Cholesterol: What It Is, Causes and How It Is Tested
High cholesterol means too much of a fatty substance in your blood, which can raise the risk of heart problems and stroke. This article explains causes, risk factors and blood tests.
Scientist and Chief Medical OfficerDr. Ambed Mishra, PharmD, PhDEducational information only, not medical advice. Always ask a qualified doctor about your own health. In an emergency call 112 (India) or 911 (US). Read the full disclaimer.
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Cholesterol is often described as bad, but your body actually needs some of it. The problem is having too much in your blood. This article explains what cholesterol is, what raises it and how it is checked, using the NHS and the US CDC.
What is cholesterol?
The CDC describes blood cholesterol as a waxy, fat-like substance made by your liver. Your body needs it for jobs such as making hormones and digesting fat, and it makes all the cholesterol it needs. The NHS says high cholesterol means having too much of this fatty substance in your blood, which can block blood vessels and raise the risk of heart problems and stroke.
The different types
The CDC explains that blood contains different fats:
- LDL cholesterol: often called bad cholesterol. High levels can lead to a build-up of plaque in the arteries, which can cause heart disease or stroke.
- HDL cholesterol: often called good cholesterol. High levels can lower the risk of heart disease and stroke.
- Triglycerides: a blood fat the body uses for energy. High triglycerides combined with low HDL or high LDL can raise the risk of heart attack and stroke.
- Total cholesterol: the overall amount, based on HDL, LDL and triglycerides.
Symptoms
The NHS says high cholesterol does not usually cause symptoms, so a blood test is the only way to find out. The CDC says the same. It explains that plaque can narrow arteries and block blood flow, which may eventually cause chest pain (angina) or a heart attack, but this is a later effect rather than a sign you can notice early on.
Causes and risk factors
The NHS lists these things that can make high cholesterol more likely:
- Being over 50, being male, or being past the menopause
- South Asian or sub-Saharan African origin
- Family history, as it can run in families
- Eating fatty food
- Not exercising enough
- Being overweight
- Smoking and drinking alcohol
The CDC also lists type 2 diabetes and a diet high in saturated and trans fats. It notes that age and family history cannot be changed, but lifestyle factors can.
How is it tested?
A blood test is used. The CDC says a cholesterol check, also called a lipid panel or lipid profile, usually measures cholesterol and triglycerides. Ask your health team how often you should be tested.
The CDC gives these optimal levels, measured in milligrams per decilitre (mg/dL):
- Total cholesterol: about 150
- LDL: about 100
- HDL: at least 40 for men and at least 50 for women
- Triglycerides: less than 150
It says a total cholesterol above 200 mg/dL may be considered high in adults and children. Your doctor looks at your results together with your other risk factors, so do not judge them in isolation.
What can be done?
The NHS says healthy eating and more exercise can help, and some people also need medicine. The CDC advises working with your health care team to prevent and manage high cholesterol. Which treatment is right for you is your doctor's decision. You can read more in our article on lowering cholesterol.
When to see a doctor
Speak to a doctor about a cholesterol test if you have risk factors such as a family history of high cholesterol, diabetes, or heart disease. The CDC suggests testing more often if you have high cholesterol or a family history of it. High cholesterol itself rarely causes symptoms, but it can contribute to heart disease.
Call emergency services at once for chest pain that does not stop, pain spreading to the arms, neck or jaw, or chest pain with sweating, sickness or breathlessness. The NHS says not to drive yourself to hospital.
In an emergency, call your local emergency number (112 in India, 911 in the United States).
Common questions
Does high cholesterol cause symptoms?
The NHS says it does not usually cause symptoms, so a blood test is the only way to find out.
What is the difference between LDL and HDL?
The CDC says high LDL can lead to plaque in the arteries and heart disease or stroke, while high HDL can lower the risk of heart disease and stroke.
What cholesterol level is considered high?
The CDC says a total cholesterol above 200 mg/dL may be considered high for adults and children. Your doctor will interpret your results.
Can cholesterol run in families?
Yes. The NHS and CDC both list family history as a risk factor for high cholesterol.
Important: please read
- Educational information only. This article is general health education. It is not medical advice, diagnosis or treatment. Reading it does not create a doctor–patient relationship with MyDoctor or with anyone else.
- Ask a qualified doctor. Always talk to a qualified, registered doctor about your own health. In India, that means a doctor registered with the National Medical Commission (NMC) or a State Medical Council. In the United States, a licensed physician. Elsewhere, a doctor licensed where you live.
- Never ignore or delay professional advice because of something you read here. Do not start, stop or change any medicine or treatment without your doctor.
- Emergencies: call 112 in India, 911 in the United States, or your local emergency number. Do not wait for an online answer.
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- About the sources. This article summarises, in our own words, information from the public health bodies named under Sources. Health knowledge changes, and this summary may not reflect the latest research or your personal situation.
- Liability. To the extent permitted by law, MyDoctor (MODERNUS HEALTH TECHNOLOGIES PRIVATE LIMITED) accepts no liability for any decision made on the basis of this content.
Sources
- NHS. High cholesterol - NHS www.nhs.uk
- CDC. About Cholesterol - CDC www.cdc.gov
Dr. Ambed Mishra, PharmD, PhD
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Dr. Ambed Mishra is a clinical (patient care) scientist, author and former professor. He is Group CEO and Chief Medical Officer of MODERN US HEALTH (MODERN US GROUP), Austin, Texas, the group behind MyDoctor, and a senior consultant who teaches and trains MD/DO physicians, PharmD and PhD professionals, nurses and other healthcare professionals in patient care in the United States and India.
More about Dr. Ambed Mishra
- More than ten years of full-time leadership in United States healthcare, building patient care services that improve medication adherence and bring doctors, pharmacists and nurses together around each patient.
- Leads the MD and engineering teams behind MyDoctor: clinic and hospital management software, electronic health records and telehealth for hospitals and physician groups in the United States and India.
- Former Assistant Professor and Clinical Preceptor at Rajiv Gandhi University of Health Sciences, Bangalore, and senior researcher with hospitals, universities and patient care groups in India and the United States.
- More than 30 published research and review articles and case reports, and more than 15 international conference presentations in India, Australia, Canada, the United States, Spain and other countries.
- Chief Medical Officer and Global Program Head of a nonprofit mission that helps cover hospital and doctor visit bills for patients in need in India, Nepal, the United States and other countries.
The author's office answers questions about articles, research, speaking and collaboration. It cannot give personal medical advice.