High Cholesterol Levels

What are high cholesterol levels?

Cholesterol is a type of fat that is naturally found in your blood, which the body uses to build healthy cells. Cholesterol also comes from the foods you eat, and mainly from animal products. Though the body produces enough cholesterol to keep your body healthy, many people eat too much cholesterol and fat, which can raise cholesterol levels to unhealthy levels.

High cholesterol levels can increase your risk for coronary heart disease. When too much cholesterol is present in the blood, it joins with other substances to form plaque, which then builds up in the walls of your arteries. Over the years, this plaque buildup causes a condition called atherosclerosis (also known as hardening of the arteries). When this happens, the arteries become narrow and slow or block the flow of blood to the heart.

If the oxygen-rich blood has trouble reaching the heart, you could experience chest pain. If the blood is blocked and cannot reach the heart, you may suffer a heart attack and have significant damage to your heart. The higher your cholesterol level, the greater your risk for developing heart disease or having a heart attack.

Types of cholesterol
Cholesterol travels through the blood by special proteins; when they are combined, they are called lipoproteins. They are two types of lipoproteins:

  • low-density lipoproteins (LDL), which are typically called “bad” cholesterol; LDLs gather cholesterol from the liver and deliver it to cells
  • high-density lipoproteins (HDL), which are known as “good” cholesterol; HDLs take excess cholesterol from the cells and bring it to the liver

Your total cholesterol level is based on the combination of LDL and HDL cholesterol.

Though high cholesterol levels can be inherited, most people get it through their lifestyle choices. Whether or not you have healthy cholesterol levels is dependent on different factors, including:

  • your level of HDL vs. LDL cholesterol
  • your the total combination of HDL and LDL cholesterol
  • your current state of health
  • your risk factors for developing heart disease
  • your age and level of activity

It is important to note that high cholesterol can be prevented and treated. The main goal of treatment in lowering cholesterol is to reduce your risk of developing heart disease or having a heart attack by lowering your level of LDL. By maintaining a healthy diet, exercising regularly, and taking the medication your doctor prescribes, you can reduce and control your high cholesterol levels.

What are the symptoms of/risk factors for high cholesterol levels?

High cholesterol itself does not cause symptoms, so people are usually unaware that their levels are too high. However, because high cholesterol levels can put you at risk for coronary heart disease, you may develop symptoms that are related to that, such as chest pains or shortness of breath. If you do have those symptoms, be sure to tell your doctor as soon as possible.

There are certain factors that may put you at higher risk of developing high cholesterol. These factors include:

  • smoking cigarettes
  • a family history of heart disease
  • age (men aged 55 or older; women aged 55 or older)
  • diabetes that requires treatment
  • a previous heart attack or stroke
  • previous artery blockages in your arms, legs, or neck
  • high blood pressure (140/90 mmHg or higher)
  • low HDL cholesterol
  • obesity (body mass index [BMI] greater than 30)
  • low level of physical activity
  • stress (which could lead you to eat fatty foods, which contain saturated fat and cholesterol)

How are high cholesterol levels diagnosed?

If you have reason to believe that you may have high cholesterol—either because of your lifestyle choices or because it runs in your family—you should schedule an appointment to see your doctor.
During your visit, your doctor will ask a number of questions about yourself, including:

  • whether your family has a history of high cholesterol, high blood pressure, heart problems, or strokes
  • whether you’ve had a test for cholesterol before (if you have, bring the results with you)
  • whether you smoke, or have been exposed to second hand smoke on a regular basis
  • what are your diet and exercise habits
  • any symptoms that may be related to your heart, such as shortness of breath or chest pains
  • what other medications, vitamins, or supplements you are currently taking

You may want to write down your answers before your appointment to make the best use of time with your doctor.

Next, the doctor will want to take blood so that a lipid panel (or profile) can be performed to get a current reading of your cholesterol levels, including:

  • total cholesterol
  • LDL cholesterol
  • HDL cholesterol
  • triglycerides (which is another type of fat in the blood)

To get the most accurate levels, the doctor may ask you not to eat or drink anything (other than water) for 9 to 12 hours before drawing the blood samples. Everyone should have lipid panel done at least once every five years.

With the lipid panel, cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. These measurements will indicate where your levels fall for each of the four types of cholesterol that are tested. The charts below show ranges for each type and which category they fall into in terms of acceptability. 

Total Cholesterol Level 

  • Desireable: Less than 200 mg/dL
  • Borderline high: 200 - 239 mg/dL 
  • High: 240 mg/dL and above

LDL Cholesterol Level

  • Optimal for those at very high risk of heart disease: Less than 70 mg/dL
  • Optimal for those at risk of heart disease: Less than 100 mg/dL
  • Near/above optimal: 100 -129 mg/dL
  • Borderline high: 130 - 159 mg/dL 
  • High: 160 - 189 mg/dL
  • Very high: 190 mg/dL or higher 

HDL Cholesterol Level

  • Poor: Less than 40 mg/dL (for men), Less than 50 mg/dL (for women)
  • Better: 40 - 49 mg/dL (for men), 50 - 59 mg/dL (for women)
  • Best: 60 mg/dL and above

Triglycerides

  • Desireable: Less than 150 mg/dL
  • Boderline High: 150 - 199 mg/dL
  • High: 200 - 499 mg/dL
  • Very High: 500 mg/dL and above

After the doctor receives your test results, ask him or her about what the results mean for you. Your doctor may recommend some lifestyle changes or medications to help control high cholesterol levels.  Even if your cholesterol levels aren’t that elevated, your doctor may decide that you need treatment based on signs of heart disease or your risk of a heart attack.

How are high cholesterol levels treated?

Once you have been diagnosed with high cholesterol levels, the next step is to lower those levels and reduce your risk for coronary heart disease. Since high LDL cholesterol is a major risk factor for heart disease, the focus of any treatment plan is lowering your LDL level. Determining your target LDL number depends on your risk factors: the higher the risk, the lower your target number. 

Treatment plans for lowering cholesterol typically involves one or both of the following approaches:

  • lifestyle changes, including a cholesterol-lowering diet, physical activity, and weight management
  • medications to help lower your LDL—which should be used in combination with your lifestyle changes

Lifestyle changes

Diet, exercise, weight management are all important because they work together to lower your LDL level. If you are a smoker, you should also make the effort to quit. The recommended lifestyles changes include:

  • a cholesterol-lowering diet that is focused on eating low saturated-fat and low cholesterol foods; your diet should only contain less than 7% of calories from saturated fat and less than 200 mg of dietary cholesterol per day. Some simple general food tips include:
    • eating fewer fats and fried foods
    • selecting foods with unsaturated fats (fats that are liquid at room temperature)
    • choosing non- and low-fat versions of foods
      eating less red meat and more fish and poultry
    • having less than 7 ounces of meat, fish, poultry, and low-fat cheese each day
    • eating more soluble fiber, such as fruit, beans, peas, and oat

      Keep in mind that you should only take in as many calories to maintain your desirable weight and avoid weight gain.
  • physical activity for at least 30 minutes most days of the week to help raise HDL and lower LDL levels; exercise is particularly important for overweight people with a large waist measurement (more than 40 inches for men, more than 35 inches for women), have high triglyceride and/or low HDL levels, and are more likely to develop heart disease
  • weight management aimed at maintaining your ideal weight; for those who are overweight, it would also involve losing excess weight to lower LDL and to reduce risk factors for those with high triglyceride and/or low HDL levels

Though making these changes can be a challenge, once you get used to them, you can apply them for the rest of your life to help keep your LDL level under control.

Medications

Some people may find that lifestyle changes alone are not enough to lower their LDL levels. Other people may have a higher risk of heart disease because of their family history with high cholesterol levels. For these people, doctors may recommend certain medications in addition to a regimen of diet, exercise, and weight management to bring their cholesterol down to a safe level.

Based on your particular needs, your doctor may prescribe one of more of the following medications to help with your blood cholesterol levels:

  • bile-acid sequestrants bind to bile (which is made mostly of cholesterol) from the liver and prevent it from being reabsorbed into your blood; this helps drain the body’s supply of cholesterol
  • cholesterol absorption inhibitors prevent cholesterol from the leaving small intestine and entering into the blood stream
  • fibric acids lower triglycerides and raise HDL cholesterol levels, however, they may have little effect on LDL cholesterol levels
  • niacin (a B vitamin) is used to increase HDL cholesterol and help remove LDL cholesterol from your bloodstream; however, it may not offer much benefit and can sometimes have dangerous side effects
  • statins lower your cholesterol and help prevent further blockage in your blood vessels and heart attacks

Advanced Cardiovascular Care at Jeanes Hospital

If you have concerns that you may have high cholesterol levels, the highly-experienced cardiologists at the Temple Heart & Vascular Institute at Jeanes Hospital are ready to assist in the diagnosis and treatment of your condition in our state-of-the-art facility at Jeanes Hospital.

The Temple cardiologists at Jeanes Hospital evaluate hundreds of patients every year, managing a wide range of serious cardiovascular conditions. After careful evaluation, they can develop and oversee a treatment plan tailored to meet your specific needs.

This is the level and quality of care you would expect to find downtown or in another city. Yet, it’s available right here, in your own community.

To schedule an appointment with a cardiologist at the Temple Heart & Vascular Institute at Jeanes Hospital, click here or call 215-728-CARE (2273).

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