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High blood cholesterol levels

Lipid disorders; Hyperlipoproteinemia; Hyperlipidemia; Dyslipidemia; Hypercholesterolemia

Cholesterol is a fat (also called a lipid) that your body needs to work properly. Too much bad cholesterol can increase your chance of getting heart disease, stroke, and other problems.

The medical term for high blood cholesterol is lipid disorder, hyperlipidemia, or hypercholesterolemia.

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Cholesterol producers
Coronary artery disease
Cholesterol
Developmental process of atherosclerosis

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Causes

There are many types of cholesterol. The ones talked about most are:

For many people, abnormal cholesterol levels are partly due to an unhealthy lifestyle. This often includes eating a diet that is high in fat. Other lifestyle factors are:

Some health conditions can also lead to abnormal cholesterol, including:

Medicines such as certain birth control pills, diuretics (water pills), beta-blockers, and some medicines used to treat depression may also raise cholesterol levels. Several disorders that are passed down through families lead to abnormal cholesterol and triglyceride levels. They include:

Smoking does not cause higher cholesterol levels, but it can reduce your HDL (good) cholesterol.

Exams and Tests

A cholesterol test is done to diagnose a lipid disorder. Some guidelines recommend having your first screening cholesterol test at age 20. Everyone should have their first screening test by age 35 in men, and age 45 in women. (Note: Different experts recommend different starting ages.)

It is important to work with your health care provider to set your cholesterol goals. Newer guidelines steer doctors away from targeting specific levels of cholesterol. Instead, it recommends different medicines and doses depending on a person's history and risk factor profile.

General targets are:

If your cholesterol results are abnormal, you may also have other tests such as:

Treatment

Steps you can take to improve their cholesterol levels, and help prevent heart disease and a heart attack include:

Your provider may want you to take medicine for your cholesterol if lifestyle changes do not work. This will depend on:

You are more likely to need medicine to lower your cholesterol:

Almost everyone else may get health benefits from LDL cholesterol that is lower than 160 mg/dL to 190 mg/dL.

There are several types of drugs to help lower blood cholesterol levels. The drugs work in different ways. Statins are one kind of drug that lowers cholesterol and has been proven to reduce the chance of heart disease.

Outlook (Prognosis)

High cholesterol levels can lead to hardening of the arteries, also called atherosclerosis. This occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called plaques.

Over time, these plaques can block the arteries and cause heart disease, stroke, and other symptoms or problems throughout the body.

Disorders that are passed down through families often lead to higher cholesterol levels that are harder to control.

Related Information

Triglyceride level
Hardening of the arteries
Hypothyroidism
Cushing syndrome
Acute kidney failure
Alcohol use and safe drinking
Overweight
Coronary heart disease
Stroke
Cholesterol - what to ask your doctor
Diabetes - what to ask your doctor - type 2
Cholesterol - drug treatment
Diabetes - preventing heart attack and stroke
Angina - discharge
Heart attack - discharge
Angioplasty and stent - heart - discharge
Aspirin and heart disease
Being active after your heart attack
Being active when you have heart disease
Butter, margarine, and cooking oils
Cardiac catheterization - discharge
Heart pacemaker - discharge
Cholesterol and lifestyle
Clopidogrel (Plavix)
Controlling your high blood pressure
Heart bypass surgery - discharge
Heart bypass surgery - minimally invasive - discharge
Dietary fats explained
Fast food tips
Heart disease - risk factors
How to read food labels
Low-salt diet
Mediterranean diet
Heart failure - fluids and diuretics
Heart failure - home monitoring
Stroke - discharge

References

Genest J, Libby P. Lipoprotein disorders and cardiovascular disease. In: Mann DL, Zipes DP, Libby P, et al. eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 45.

Haney EM, Huffman LH, Bougatsos C, Freeman M, Fu R, Steiner RD, Helfand M, Nelson H, eds. Screening for Lipid Disorders in Children and Adolescents [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007 Jul. Report No.: 07-0598-EF-1 PMID: 20722144 www.ncbi.nlm.nih.gov/pubmed/20722144.

Helfand M, Carson S, eds. Screening for Lipid Disorders in Adults: Selective Update of 2001 US Preventive Services Task Force Review [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Jun. Report No.: 08-05114-EF-1 PMID: 20722146 www.ncbi.nlm.nih.gov/pubmed/20722146.

Semenkovich, CF. Disorders of lipid metabolism. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 206.

Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM, McBride P, Schwartz JS, Shero ST, Smith SC Jr, Watson K, Wilson PWF. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Jun 24;129(25 Suppl 2):S46-8. PMID: 24222016 www.ncbi.nlm.nih.gov/pubmed/24222016.

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Review Date: 4/20/2015  

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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