What Is Considered High Cholesterol?

In the United States, high cholesterol has become a significant problem, affecting nearly 94 million¹ individuals aged 20 and older. High cholesterol can go unnoticed for an extended period, as it rarely manifests symptoms.

If you're having trouble figuring out what high cholesterol is or how to tell whether you have it, a lipoprotein panel blood draw can assist you in determining your cholesterol levels.  This test is most accurate if you fast 8 to 12 hours before the test.

What is high cholesterol?

Cholesterol is a waxy fat-like substance found in all of your body's cells. It is made naturally by the liver, but it can also be found in some foods, like meat and dairy products. Cholesterol is necessary for producing cell membranes, hormones, and vitamin D in the body.

Cholesterol does not dissolve in water; therefore, it cannot flow through your bloodstream on its own. As a result, your liver generates lipoproteins, which are fat and protein-based particles that transport cholesterol and another form of lipid, triglycerides, through the bloodstream. Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) are the two main types of lipoprotein.

Any cholesterol transported by low-density lipoproteins is referred to as LDL cholesterol. When the blood contains too much LDL cholesterol, you may be diagnosed with high cholesterol. If this condition is left untreated, it can lead to various health problems, including coronary artery disease.

Types of cholesterol

LDL cholesterol

LDL cholesterol is commonly referred to as bad cholesterol. It transports cholesterol to the cells of the body. LDL cholesterol can develop on arterial walls, forming cholesterol plaque if your levels are too high.

Cholesterol plaque is a deposit that can clog your arteries, reduce blood flow, and increase your risk of blood clots. Coronary artery disease occurs when a blood clot slows or stops blood flow in your heart or brain artery.

HDL cholesterol

HDL cholesterol is often known as "good cholesterol." It aids in the removal of cholesterol from the blood vessels by returning it to your liver, thus reducing the buildup of cholesterol plaque in the arteries. HDL cholesterol levels that are healthy can help reduce the risk of blood clots, heart disease, and stroke.

Triglycerides

Another form of lipid is triglycerides.²

When you consume excess calories, mainly from high carbohydrate foods, those calories are converted to triglycerides. Triglycerides are stored in fat cells and can later be released for energy. 

A high triglyceride level can put you at risk for various illnesses, such as heart disease and stroke.

Cholesterol levels

Physicians classify cholesterol levels as desirable, borderline high, or high cholesterol:

• Less than 200 mg/dL is categorized as desirable

• 200–239 mg/dL is classified as borderline high

• 240 mg/dL and above is classified as high

They may also classify LDL cholesterol as optimal to high, as indicated below:

• Less than 100 mg/dL is optimal

• 100–129 mg/dL as near-optimal

• 130–159 mg/dL is borderline high

• 160–189 mg/dL is high

• 190 mg/dL and above is very high

These are approximate figures, and it is upon you and your doctor to consider other personal aspects such as lifestyle and health conditions before settling on a treatment strategy.

Symptoms of high cholesterol

High cholesterol is usually a "quiet" problem. It doesn't usually exhibit symptoms. Therefore, one is likely to remain unaware of its existence until one develops conditions such as coronary artery illness.

That's why it's critical to get your cholesterol checked regularly. If you're over 20 years old, check with your doctor if you should undergo a routine cholesterol check.

Complications of high cholesterol

High cholesterol, if left untreated, can result in plaque buildup in the arteries, which can reduce blood flow through these arteries, resulting in atherosclerosis. This disease results in lower blood flow in the arteries, increasing the risk of heart attack,  stroke, and peripheral artery disease.  These conditions can be life-threatening.

High cholesterol causes

Certain factors may lead to high cholesterol levels. Below are some of the factors that can affect a person’s cholesterol level and one’s risk factors for developing the disease.

Factors that can affect the cholesterol level

High cholesterol levels can result from a variety of factors, such as:

Unhealthy lifestyle

Consuming cholesterol-rich, saturated-fat-rich, and trans-fat-rich foods raise the risk of developing high cholesterol. Obesity can also make you more vulnerable, while inactivity and smoking are other lifestyle variables that might contribute to high cholesterol.

Genetics

Your genetics can also leave you more susceptible to developing high cholesterol. Parents pass on their genes to their children. Your body receives instructions from specific genes on metabolizing cholesterol and lipids. If one or both of your relatives have high cholesterol, you may be more likely to develop it.

Familial Hypercholesterolemia

This hereditary condition leaves your body unable to remove LDL from the bloodstream. Most persons with familial hypercholesterolemia have total cholesterol levels of more than 300 mg/dL and LDL values of more than 200 mg/dL.

Other health conditions

Diabetes and hypothyroidism, for example, can raise your chances of getting high cholesterol and its problems.

Risk factors for developing high cholesterol

The following are some risk factors for high cholesterol:

Race

High cholesterol may be more common in certain races. Blacks, for example, have greater HDL and LDL cholesterol levels than white people.

Age

As you become older, your cholesterol levels tend to rise. Younger adults, such as kids and teenagers, can also have high cholesterol, though it is less prevalent.

Genetics

High cholesterol levels in the blood can run in families.

Weight

Obesity or being overweight increases your cholesterol level.

Treatment

Your doctor may recommend drugs to help you reduce your cholesterol levels in some instances.

The most typically given drugs for high cholesterol are statins which mainly consist of atorvastatin, simvastatin, fluvastatin, and rosuvastatin. They reduce the production of cholesterol by the liver.

Other high-cholesterol medications that your doctor may give include:

• Bile acid resins or sequestrants, such as colesevelam (Welchol), colestipol (Colestid), or cholestyramine (Prevalite)

• Niacin

• Cholesterol absorption inhibitors, such as ezetimibe (Zetia)

• PCSK9 inhibitors, such as alirocumab (Praluent)  and evolocumab (Repatha), which are injection forms

Prevention of high cholesterol

If you have high cholesterol, your doctor might suggest adjustments such as eating foods low in cholesterol and exercising regularly. They will also most certainly urge you to quit smoking.

Using diet to lower cholesterol level

Reducing your dietary fat intake is a vital first step in lowering your cholesterol level, regardless of the level.

Your doctor may recommend  an effective diet that involves:

• Reducing your intake of cholesterol-rich, saturated-fat-rich, and trans-fat-rich foods

• Picking lean protein sources, including chicken, fish, and lentils

• Consuming a diverse range of high-fiber foods, like vegetables, whole grains, and fruits

• Eating baked, broiled, stewed, grilled, or roasted dishes instead of fried ones

• Avoiding fast food and fatty, pre-packaged meals

Cholesterol-rich, saturated-fat-rich, and trans-fat-rich foods include:

• Items that are deep-fried, such as potato chips, onion rings, and fried chicken, and baked pastries, such as cookies and muffins

• Red meat, organ meats, egg yolks, and high-fat dairy products are all high in saturated fat

• Cocoa butter or palm oil-based processed foods

Consuming other omega-3-fatty-acid-rich foods can also help decrease your LDL levels. For instance, herring, mackerel, and salmon are high in omega-3s.  Avocados, walnuts, ground flaxseeds, and almonds also contain omega-3s.

How to prevent high cholesterol

While it is not possible to reduce your hereditary risk factors for high cholesterol, lifestyle variables can be controlled.

To reduce your chances of acquiring high cholesterol, do the following:

• Avoid smoking

• Consume a well-balanced diet rich in fiber and low in cholesterol and animal fats

• Maintain a healthy body weight

• Avoid excessive alcohol usage

• Exercise regularly

For routine cholesterol screening, adhere to your doctor's advice. If you're at risk for high cholesterol or cardiovascular disease, they'll probably recommend that you have your cholesterol levels checked regularly.

When to see the doctor

If you're over the age of 20, you should have your cholesterol levels examined every 4 to 6 years because high cholesterol rarely manifests symptoms. It's also good to have your cholesterol levels reviewed more frequently if you have a history of high cholesterol or other heart disease risk factors.

The lowdown

High cholesterol occurs when your body produces too much LDL cholesterol. In most cases, the ailment has no symptoms, making it difficult for people to recognize that they have it. If the illness is not treated, it can lead to significant health issues like coronary artery disease and stroke. 

Your doctor can assist you in managing this illness and, in many circumstances, prevent consequences. Asking your doctor to examine your cholesterol levels is the only way to determine if you have high cholesterol. Inquire about your treatment choices if you've been diagnosed with high cholesterol.

Adopt healthy lifestyle behaviors and stick to your doctor's medication plan to reduce your chance of high cholesterol issues.