Many things can cause high cholesterol, including:
- Diet. Eating too much saturated fat and cholesterol can
raise your cholesterol. Saturated fat and cholesterol are in foods that come
from animals (such as beef, pork, veal, milk, eggs, butter, and cheese), many
packaged foods, stick margarine, vegetable shortening, and snack foods like
cookies, crackers, and chips. - Weight. Being overweight may raise triglycerides and
lower “good” HDL. - Activity level. Not exercising may raise “bad” LDL and
lower HDL. - Overall health. Diseases such as hypothyroidism can raise
cholesterol. Smoking may lower HDL. - Age. Cholesterol starts to rise after age 20. In men, it
usually levels off after age 50. In women, it stays fairly low until
menopause. After that, cholesterol levels rise to about the same levels as in
men. - Family. Some people inherit a rare disease called a lipid
disorder. It can cause very high total cholesterol, very low HDL, and high
triglycerides. If you have this problem, you will need to start treatment at a
young age.
How is high cholesterol diagnosed?
Doctors use a blood test to check cholesterol.
- A fasting cholesterol test (also called a lipoprotein
analysis) is the most complete test. It measures total cholesterol, HDL, LDL,
and triglycerides. You cannot have food for 9 to 12 hours before this test.
- A simple cholesterol test can measure total cholesterol
and HDL. You can eat before this test. Sometimes doctors do this test first.
If it shows you have high cholesterol or low HDL, then you will get a fasting
cholesterol test.
How is it treated?
The two main treatments are lifestyle changes and medicines. The goal of
treatment is to lower your "bad" LDL cholesterol and reduce your risk of a
heart attack. You may also need to
raise your "good" HDL cholesterol. A high level of HDL helps reduce your risk of
heart problems.
Some lifestyle changes are important for everyone with high cholesterol. Your
doctor will probably want you to:
- Follow the Therapeutic Lifestyle Changes (TLC) diet. The
goal is to reduce the amount of saturated fat you eat. Eating saturated fat
raises your cholesterol. The TLC diet helps you learn to make better food
choices by picking lean meats, low-fat or nonfat products, and good fats like
olive and canola oils. - Lose weight, if you need to. Losing just 5 to 10 pounds
(2.3 to 4.5 kilograms) can lower your cholesterol and triglycerides. Losing
weight can also help lower your blood pressure. - Be more active. Exercise can raise your “good” HDL and
may help you control your weight. - Quit smoking, if you smoke. Quitting can help raise your
HDL and improve your heart health.
Sometimes lifestyle changes are enough on their own. But if you try them for
a few months and they don't lower your cholesterol enough, your doctor may
prescribe a cholesterol-lowering medicine called a statin. You also may need
medicines to lower triglycerides or raise HDL.
You may need to start taking medicine right away if your cholesterol is very
high or if you have another problem that increases your chance of having a heart
attack. People who have a high risk for heart attack benefit from taking higher
doses of statins to lower their LDL cholesterol as much as possible. The more
these people can lower their LDL, the less likely they are to have a heart
attack. To find out your risk, use this Interactive Tool: Are You at Risk for a
Heart Attack?
It is important to take your medicine just the way your doctor tells you to.
If you stop taking your medicine, your cholesterol will go back up.
You will need to have your cholesterol checked regularly. Your results can
help your doctor know if lifestyle changes have helped or if you need more or
different medicines.