Understanding Cholesterol and Lipids: Your Complete Guide to LDL, HDL, Triglycerides and Lipoprotein(a)
Quick Facts About Cholesterol
- Cholesterol comes from two sources. Your liver makes all the cholesterol you need. The rest of the cholesterol in your body comes from food from animals.
- When cholesterol levels stay high over time, it can affect your heart health.
- Many people with high cholesterol do not have symptoms. A simple blood test, also called a lipid panel, can show where your levels are.
What is cholesterol, and why does it matter for heart health?
Cholesterol is a waxy substance your body uses for many important functions. It can become a concern when levels increase too high over time. Understanding your levels can help you make informed choices about supporting your heart health.
What are normal cholesterol levels for adults?
Healthy cholesterol levels depend on your individual health. The 91视频 does not recommend a single “normal” total cholesterol number for everyone. A total cholesterol below 200 mg/dL has long been considered healthy, and it is often used as a screening measure. Total cholesterol is not a treatment target for lowering heart disease or stroke risk, and it should not be interpreted on its own. However, your health care professional may still consider total cholesterol when assessing your overall risk.
How can I lower my cholesterol level?
You might consider adding more physical activity that you enjoy, finding ways to reach or maintain a healthy weight and eating more vegetables, fruits and whole grains. If you smoke, quitting can be one of the most powerful steps you can take for your heart.
How does high cholesterol increase the risk of heart disease and stroke?
When cholesterol levels stay elevated, cholesterol can join with other substances to form a thick, hard deposit on the inside of the arteries. Over time, this narrows the arteries and makes them less flexible — a condition known as鈥�atherosclerosis. This may eventually block blood flow, which can lead to a鈥�heart attack&苍产蝉辫;辞谤鈥�.
What is atherosclerosis and how does it develop?
Atherosclerosis happens when cholesterol and other substances build up in the arteries over time, narrowing them and reducing blood flow. It often happens gradually, but it can raise the risk of heart attack or stroke if plaques limit or block circulation. Understanding how cholesterol plays a role can help you take steps that support your heart health, whether that be through everyday habits or medical care. Learn more about how atherosclerosis develops and what it means for your heart health.
What is hyperlipidemia?
Hyperlipidemia is a term that describes higher levels of blood lipids, or fats, such as cholesterol and triglycerides.
How is hyperlipidemia different from high cholesterol?
These terms are closely related. Hypercholesterolemia is a type of hyperlipidemia. Both describe when your blood contains more non-HDL cholesterol and鈥�LDL (bad) cholesterol than your body can easily manage, over time, this can increase cardiovascular disease risk.
What is a lipid panel, and what does it measure?
A lipid panel is a simple blood test that gives you a snapshot of your cholesterol, including HDL (good), LDL (bad), and triglycerides. Knowing your numbers can help you and your health care professional understand what’s happening in your body and which steps might support your heart health. For many adults, checking cholesterol every five years is a good starting point. Your timing might vary based on your personal risk and your health care professional’s recommendation.
How can I talk with my health care professional about cholesterol?
By working together, you and your health care professional can explore options that fit your situation. Coming prepared with questions can help you get the most from your visit. Consider these questions to help start the conversation.
Understanding My Cholesterol Risk (PDF)(link opens in new window)
Beyond the Standard Cholesterol Test
What is an advanced lipid panel, and how is it different from a standard cholesterol test?
Beyond a standard cholesterol test, there are extra tools that can offer a deeper look at your heart health. Tests including advanced lipid panels, Lp(a), ApoB, CAC scans and hsCRP can provide more information about plaque buildup, inflammation and inherited risk. Not everyone needs these tests, but for some people, they can help guide more personalized decisions about prevention and care. Explore cholesterol testing options and what they measure.
What is HDL cholesterol, and why is it called “good” cholesterol?
HDL cholesterol earns its “good” reputation because it helps move excess cholesterol away from the arteries and back to the liver for processing. While it is just one part of your overall cholesterol picture, higher levels may help protect against heart attack and stroke.
What is a good HDL cholesterol level?
Your target HDL cholesterol levels depend on your overall cardiovascular health. According to the 91视频, HDL is not a treatment target for lowering heart disease or stroke risk. It should not be interpreted on its own. However, your health care professional still considers HDL levels when assessing your overall risk for heart disease or stroke. People with higher HDL levels may have a lower risk of heart attacks and .
How can I increase HDL cholesterol naturally?
Everyday habits such as staying active, eating a balanced diet and avoiding tobacco can help support healthy HDL levels over time. Small, sustainable changes can often work better than dramatic lifestyle changes
What is LDL cholesterol, and why is it bad for heart health?
LDL cholesterol is often called “bad” cholesterol because it can build up in arteries over time, increasing the risk for鈥�heart attack,鈥�&苍产蝉辫;补苍诲鈥�peripheral artery disease, or鈥疨AD.
What causes high LDL cholesterol?
Levels can be influenced by factors including family history, daily habits and underlying conditions such as familial hypercholesterolemia鈥�(FH), an inherited condition in which people are born with very high LDL cholesterol levels
What is a normal LDL cholesterol level?
There isn’t one “normal” LDL level that works for everyone. Lower LDL levels are linked with better heart and brain health, and the right goal for you depends on various factors related to your health. Your LDL goal may be based on things such as:
- Age
- Overall health
- Family history
- Whether or not you have diabetes (Type 1 or Type 2 )
- History of heart attack or stroke
For some people, an LDL goal may be below 100 mg/dL. For others, the goalit may be below 70 mg/dL or below 55 mg/dL for people at very high risk of a heart attack or stroke. Your health care professional can help determine the goal that’s right for you.
How can I lower my LDL cholesterol?
The good news is there are many ways to support healthy LDL levels, from healthy鈥痩ifestyle habits鈥� to medications if needed. You can work with your health care professional to find a treatment plan that fits your life. This helpful guide can help you review your risks and discuss the best treatment options with your health care team.
贬别补濒迟丑测鈥�lifestyle habits such as eating well and being physically active can make a difference in cholesterol levels. Sometimes lifestyle changes aren’t enough, and that’s OK. You and your health care professional can work together to explore options that fit your situation. This helpful LDL cholesterol treatment plan (PDF)(link opens in new window)(link opens in new window) can help you review your risks and discuss the best treatment options with your health care team.
What are triglycerides, and why do they matter for heart health?
Triglycerides are the most common type of fat in the body. They store excess energy from your diet. High triglycerides can affect heart health, especially when combined with high LDL cholesterol or low HDL cholesterol.
You don’t need to change everything at once. Even small lifestyle shifts can help improve your lipid profile. Learn more about triglycerides and how they fit into your cholesterol profile.
Cholesterol and Other Risk Factors
Some health conditions, when combined with high cholesterol, can increase your risk of a heart attack or stroke. These conditions include Type 2 diabetes, cardiovascular-kidney-metabolic syndrome, HIV infection, history of cancer or current cancer diagnosis. Managing cholesterol can help reduce risk.
How does managing these conditions impact your heart health?
- Diabetes often lowers “good” cholesterol levels and raises triglycerides and “bad” cholesterol levels. This increases the risk for heart disease and stroke. This condition is called diabetic dyslipidemia. It means your lipid profile is going in the wrong direction.
- High blood pressure can harm your arteries, and that damage makes it easier for cholesterol to stick and form plaque. When both conditions are present, your risk for heart disease and stroke goes up a lot. Managing both conditions together can make a real difference for your heart health.
The 91视频 is raising awareness about the connections between conditions to help people understand the various ways to prevent, treat and manage their overall health.
Your Health Is Connected: Four Different Systems. One Healthy You.
Familial hypercholesterolemia (FH)
What is familial hypercholesterolemia (FH)?
Familial Hypercholesterolemia, or FH, is聽an inherited condition that makes it harder for the body to remove LDL (鈥渂ad鈥�) cholesterol from the blood. If not identified and treated early in life, people with FH are at increased risk for premature heart disease and stroke.聽
What are the types of FH?
There are two types of FH:鈥�
- Homozygous familial hypercholesterolemia (HoFH)
- Heterozygous familial hypercholesteremia (HeFH)
What are the signs and symptoms of FH?
Some people with FH have physical symptoms. Many don鈥檛. One symptom is cholesterol deposits in the Achilles tendons or the tendons of the hands or elbows. People with HoFH also can develop cholesterol deposits in other areas, such as the skin surrounding the eyes or on the outer edge of the cornea.
How is FH diagnosed and treated?
Both types of FH can be diagnosed with a physical exam, blood lab results and personal and family history. If one person in a family has FH, then it鈥檚 important for parents, siblings and children to be checked for it. Similarly, if someone in a family has an early heart attack, it鈥檚 a good idea for other family members to get tested.
- For children with increased risk for FH, it is reasonable to be screened starting at age 2. All children should have their cholesterol checked between ages 9 and 11 and again at age 19.
- FH cannot always be treated by diet and exercise alone. Lifestyle changes can help, but cholesterol-lowering medication may be recommended to lower LDL cholesterol.
How can familial hypercholesterolemia be treated?
Heart-healthy lifestyle habits remain important for everyone with FH. Depending on a person鈥檚 age and cholesterol levels, FH may require cholesterol -lowering medication to effectively lower LDL cholesterol.
Lipoprotein(a) - Understanding Lp(a) and Heart Disease Risk
What is lipoprotein(a), or Lp(a), and why should you test it?
Lp(a) stands for lipoprotein(a) and is pronounced 鈥淟-P- little-a.鈥� Recent guidance from the 91视频 recommends every adult get their Lp(a)聽tested at least once in a lifetime. Lp(a) is a type of lipoprotein that is inherited. A high Lp(a) can cause plaque buildup and reduced blood flow, increasing the risk of heart disease and stroke.
How does cascade screening work for family members?
Lp(a) is an inherited risk factor for heart disease and affects about 1 in 5 people worldwide. Cascade screening聽is a way to check if family members of someone with a genetic condition might have the same gene change.
Can lifestyle lower Lp(a)?
While lifestyle changes can鈥檛 lower Lp(a) levels, you can focus on reducing your overall heart health risk by:
- Eating a heart-healthy diet
- Getting regular physical activity
- Reaching or maintaining a healthy weight
- Avoiding tobacco products
- Managing blood pressure, diabetes and cholesterol
- Getting restful sleep
Heart-Healthy Diet for Cholesterol Management
- Focus on foods you enjoy, such as colorful fruits and vegetables, nuts, beans, legumes, whole grains, fiber and lean protein (plants, fish, lean meats). Making聽healthier recipes doesn鈥檛 mean giving up flavor.
- Cooking tips for heart health. Start small. You might try swapping one ingredient in a favorite recipe or try one new heart-healthy meal each week. You don鈥檛 have to sacrifice flavor to eat well for your health. These simple tips for cooking to lower cholesterol can help you prepare tasty, heart-healthy recipes that could help improve your cholesterol levels by reducing excess saturated fat and trans fat.鈥�
- Does the keto diet affect cholesterol levels? Yes. The keto diet can affect cholesterol levels. Very low鈥慶arb or keto diets do not typically align with heart鈥慼ealthy eating guidelines because they are often high in saturated fat. Eating more saturated fat may raise LDL (bad) cholesterol. These diets can also be hard to follow over time and are not more effective for long鈥憈erm weight loss than less strict eating plans. If you're considering major dietary changes for cholesterol control, talking through options with your health care team can help you find safe, effective approaches.
Physical Activity for Cholesterol
- How does physical activity help lower cholesterol? Moving your body helps bring down LDL (bad) cholesterol and raise HDL (good) cholesterol. When you move more, your body becomes better at clearing out extra cholesterol from your blood. This helps keep your arteries clearer and reduces your risk of heart disease and stroke. Find activities you fully enjoy such as walking, dancing, swimming or even gardening.
- The most effective exercise for lowering cholesterol is the kind you鈥檒l actually do consistently. Choose what feels doable for you and build from there. About 150 minutes of moderate-intensity activity weekly can make a difference.
Cholesterol-Lowering Medications - When Lifestyle Isn't Enough
- When do I need medication for high cholesterol? High LDL (bad) cholesterol increases the risk of heart attack and stroke. A healthy diet and exercise help, but sometimes cholesterol-lowering medication is needed, too. Our Cholesterol-Lowering Medications Discussion Guide (PDF)(link opens in new window)(link opens in new window) can help you and your health care professional work together to discuss the best treatment options for you.
- What types of cholesterol-lowering medications are available? There are many medications that can help lower cholesterol. Our resource What Are Cholesterol-Lowering Medications? (PDF)(link opens in new window)(link opens in new window) explains the most common ones, including statins, ezetimibe, PCSK9 inhibitors and bile acid medicines. It also shows how each one works differently to help lower cholesterol.
- Statins are the most commonly prescribed cholesterol-lowering medication and can effectively lower LDL cholesterol and reduce cardiovascular disease risk. Your health care professional can help you understand statin benefits, potential side effects and whether statin therapy is right for you.
Heart-Healthy Diet for Cholesterol Management
- The way you eat can play an important role in your cholesterol levels. But there is no one-size-fits-all approach. Focus on foods you enjoy, such as colorful vegetables and fruits, nuts, beans, legumes, whole grains, fiber and lean protein (plants, fish, lean meats). Start small. You might try swapping one ingredient in a favorite recipe or try one new heart-healthy meal each week. You don’t have to sacrifice flavor to eat well for your health. These simple cooking tips can help you prepare tasty, heart-healthy that could help improve your cholesterol levels by reducing excess saturated fat and trans fat.
- Does the keto diet affect cholesterol levels? Some diets, such as keto, may raise LDL (bad) cholesterol because they are often higher in saturated fat, and they can be hard to maintain over time.
Physical Activity for Cholesterol
How does physical activity help lower cholesterol? Regular physical activity can help improve cholesterol by lowering LDL and raising HDL (good) cholesterol. Finding habits you enjoy, such as walking, dancing, swimming or even gardening, can make it easier to build lasting changes.
Explore heart-healthy ways to prevent and manage high cholesterol.
Cholesterol Management Tools and Resources
- My Cholesterol Guide
- Learn more about our cholesterol tools and resources
- : Talk with your health care team about PREVENT, a tool that can help estimate your chances of having a heart event or stroke in the next 10 and 30 years. This information helps guide treatment plan decisions for you and your health care team.
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