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How to Lower Cholesterol

What Is Cholesterol?

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Cholesterol is a waxy, fat-like substance that is naturally present in cell walls or membranes everywhere in the body. Your body uses cholesterol to produce many hormones, vitamin D, and the bile acids that help to digest fat.

High cholesterol levels in the blood can cause fatty deposits in blood vessels which cause narrowing and may lead to heart attack, stroke, or peripheral artery disease.

What Causes High Cholesterol?

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The most common causes of high cholesterol are all related and include a high fat diet, inactivity, and obesity. Less commonly, genetic causes can decrease the ability of the body to metabolize cholesterol or cause the liver to produce too much cholesterol.

How Often Should I Have My Cholesterol Checked?

The American Heart Association recommends that blood cholesterol levels should be checked every 5 years after the age of 20. If cholesterol levels are high (usually over 200 mg dL), people are often started on medicine to reduce the cholesterol and are usually advised to begin a low-cholesterol diet. Then the cholesterol levels are usually checked about every three months to see if the levels normalize. Once the levels normalize, they are often rechecked at least once per year by many health-care professionals.

How Is Cholesterol Checked?

Cholesterol screening is part of a blood test called a lipoprotein analysis that measures not only total cholesterol in the body but also different types of cholesterol and triglycerides (another type of fat in the body). Total cholesterol is made up two types of cholesterol;

  1. High density lipoproteins (HDL) which may protect the body against narrowing blood vessels and is considered good cholesterol, and
  2. Low density lipoproteins (LDL) is considered bad cholesterol and may make arterial narrowing worse.

The test is done after a 9 to 12 hour fast and your health-care professional can help interpret the results and decide whether treatment is required.

What Are LDL and HDL cholesterol ranges (charts)?

Just knowing your total cholesterol isn't enough. Not only does the total cholesterol number need to be normal but HDL and LDL numbers need to be in the appropriate range. Normal total cholesterol associated with a high LDL may still increase the risk of heart disease and stroke. Triglyceride levels also need to be controlled.

Total Cholesterol Ranges
Less than 200 mg/dL: desirable
200-239 mg/dL: borderline high risk
240 and over: high risk

HDL (high density lipoprotein) ranges
Less than 40 mg/dL (men), less than 50 mg/dL (women): increased risk of heart disease
Greater than 60mg/dL: some protection against heart disease

LDL (low density lipoprotein) ranges
Less than 100 mg/dL: optimal
100-129 mg/dL: near optimal
130-159 mg/dL: borderline high
160- 189 mg/dL: high
190 mg/dL and above: very high

Triglyceride ranges
Less than 200 mg/dL: desirable
Less than 150 mg/dL: normal
150-199 mg/dL: borderline to high
200-499mg/dL: high
500 mg/dL: very high

Which Risk Factors for High Cholesterol Are Controllable and Uncontrollable?

A person can control lifestyle options to maximize their potential to control high cholesterol levels with a healthy diet, exercise, weight control, and avoiding or quitting smoking.

However, there are some situations that are beyond control of the individual. Family history and genetic predisposition to high cholesterol, aging (men older than 45 and women older than 55), and diseases that cause the liver to produce more cholesterol or prevent it from metabolizing cholesterol are risk factors for high cholesterol. These risks can be minimized by living a healthier lifestyle but may require cholesterol-lowering medication.

Medically Reviewed by a Doctor on 12/9/2016

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Patient Comments & Reviews

The eMedicineHealth doctors ask about How to Lower Cholesterol:

Cholesterol - Prevention

What steps have you taken to control your high cholesterol?

How To Lower Cholesterol - Experience

Please share your experience with lowering your cholesterol.

How To Lower Cholesterol - Causes

If known, what caused your cholesterol levels to rise?

Cholesterol Lowering Medications

If lifestyle changes such as diet, exercise, and weight loss don't lower your cholesterol enough your doctor may prescribe a cholesterol lowering medication. There are a variety of medications to lower cholesterol, for example:

  • Statins
  • Bile acid sequestrants
  • Fibrates
  • Nicotinic agents
  • Cholesterol absorption inhibitors
  • PCSK9 inhibitors

Read What Your Physician is Reading on Medscape

High HDL Cholesterol (Hyperalphalipoproteinemia) »

High-density lipoprotein (HDL) is positively associated with a decreased risk of coronary heart disease (CHD).

Read More on Medscape Reference »

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