Should You Care If Your Cholesterol Levels Are High?

Part 1 of a 2-Part Series On Cholesterol Risks and Management

​

When most people hear the word “cholesterol,” they automatically link it to cardiovascular disease, including heart attacks, strokes and peripheral vascular disease. Yet it really is not as simple as that.

“People often think that cholesterol is a bad thing, but cholesterol is actually something our bodies need,” says Dr. Lincy Mathew, an internal medicine specialist with Washington Township Medical Foundation.

“Cholesterol is a type of fat known as a lipid,” she explains. “It is an essential building block for cell membranes, hormones such as testosterone and estrogen, vitamin D, and substances we need to digest and absorb foods. The body also needs cholesterol to build the protective sheath that surrounds nerve fibers. Most cholesterol is produced by the liver, but we also get cholesterol from some of the foods we eat.”

Cholesterol is carried through the blood by molecules called lipoproteins that are made up of lipids on the inside and proteins on the outside. There are two kinds of lipoproteins – low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

“LDL cholesterol is sometimes called the ‘bad’ cholesterol, because a high level of LDL cholesterol can lead to a buildup of hard deposits called plaques that can clog the arteries and make the arteries less flexible,” says Dr. Mathew. “If a plaque ruptures, it can result in a heart attack or a stroke. In addition, plaque buildup also can cause peripheral artery disease that restricts the blood supply to the legs and arms.

“HDL cholesterol is sometimes called the ‘good’ cholesterol, because it carries cholesterol from other parts of the body back to the liver, which removes that cholesterol from the body,” she continues. “So, in general, a high level of LDL cholesterol in your blood increases your chances of cardiovascular disease, while low levels of HDL cholesterol have been shown to increase your risks for cardiovascular disease. A higher level of HDL lowers your chance of developing cardiovascular disease.”

Triglycerides are another type of fat in your blood that the body uses for energy. The combination of high levels of triglycerides with low HDL cholesterol or high LDL cholesterol can increase your risk for cardiovascular disease. To check your cholesterol levels, including triglycerides, your physician can order a simple blood test called a lipid profile.

“High cholesterol levels usually don’t produce any symptoms,” Dr. Mathew notes. “That’s why it is important to have cholesterol screenings, including the level of triglycerides, at regular intervals, depending upon your risk factors. In general, men should start cholesterol screenings at age 35, and women should start screenings at age 45. If there are significant risk factors for cardiovascular disease – such as a strong family history of cardiovascular disease, or a personal history of high blood pressure, obesity or smoking – then the screenings should begin 10 years earlier, at age 25 for men and age 35 for women.”

The National Institutes of Health (NIH) gives the following general guidelines for evaluating your cholesterol and triglyceride levels, measured in milligrams (mg) of cholesterol per deciliter (dL) of blood:

Total Cholesterol Levels
Less than 200 mg/dL – desirable
200-239 mg/DL – borderline high
240 mg/dL and above – high

LDL (Bad) Cholesterol Levels
Less than 100 mg/dL – optimal
100-129 mg/dL – near optimal
130-159 mg/dL – borderline high
160-189 mg/dL – high
190 mg/dL and above – very high

HDL (Good) Cholesterol Levels
Less than 40 mg/dL – a major risk factor for cardiovascular disease
40-59 mg/dL – the higher, the better
60 mg/dL and higher – considered protective against cardiovascular disease

Triglyceride Levels
Less than 150 mg/dL – normal
150-199 mg/dL – borderline high
200-499 mg/dL – high
500 mg/dL and above – very high

“You can’t make a blanket statement about how often to screen for cholesterol,” says Dr. Mathew. “The general recommendation for screening intervals in the U.S. is every five years for people with no risk factors. The frequency of screening should be based on each patient’s risk factors and circumstances, with shorter intervals for persons who have lipid levels close to those warranting therapy and longer intervals for those not at increased risk who repeatedly have had normal lipid levels.”

Learn More

Part 2 of this series on cholesterol will discuss ways to manage your cholesterol levels and lower your risks for cardiovascular disease.

If you need help finding a personal physician, click here.

For information about cholesterol from the NIH, click here.

For information about cholesterol from the American Heart Association, click here.

To calculate your risk for cardiovascular disease using the American Heart Association’s CV Risk Calculator, click here.