Cholesterol Levels: Healthy Numbers, Testing and How to Lower Them

What cholesterol is

Cholesterol is a waxy, fat-like substance found in all the cells of your body. You need some to function, but too much in your blood can stick to artery walls and narrow or even block them, raising your risk of coronary artery disease and other heart diseases.

The test

A blood test called a lipoprotein panel or lipid panel measures your cholesterol. You will need to fast — nothing but water — for 9 to 12 hours beforehand. It reports:

• Total cholesterol — all the cholesterol in your blood, including LDL and HDL.
• LDL (low-density lipoprotein) — often called "bad" cholesterol, the main source of buildup and blockage in arteries.
• HDL (high-density lipoprotein) — often called "good" cholesterol, because it helps remove cholesterol from arteries.
• Non-HDL — total cholesterol minus HDL, which includes LDL and other types such as VLDL (very-low-density lipoprotein).
• Triglycerides — another blood fat, not a cholesterol, which can raise heart disease risk, especially in women.

Healthy levels

Numbers are in milligrams per deciliter (mg/dL). What is best for you may depend on your age, race, blood pressure, weight, family history and more, so ask your provider. General guidelines for healthy levels:

A normal triglyceride level is below 150 mg/dL. You may need treatment if yours is borderline high (150–199) or high (200 or more).

How often to be tested

It depends on your age, risk factors and family history. In general:

• Children and teens: a first test at 9 to 11, then every 5 years — some from age 2 if the family has a history of high cholesterol, heart attack or stroke.
• Adults 20 to 65: younger adults every 5 years; men 45 to 65 and women 55 to 65 every 1 to 2 years.
• Over 65: every year.

What affects your levels

Things you can change:

• Diet. Saturated fat and cholesterol in food raise blood cholesterol; saturated fat is the main problem. It is high in red meat, full-fat dairy, chocolate, some baked goods, and deep-fried and processed foods.
• Weight. Overweight and obesity are heart disease risk factors and tend to raise cholesterol.
• Physical inactivity, a risk factor for heart disease.
• Smoking, which lowers HDL — and less HDL to clear arteries can mean higher cholesterol.

Things you cannot change:

• Age. Levels tend to rise with age, though children and teens can have high cholesterol too.
• Sex. From 20 to 39, men are at greater risk of high total cholesterol; after menopause, which lowers female hormones that may protect against it, women's risk rises.
• Family history. Your genes partly decide how much cholesterol your body makes, and high cholesterol runs in families.
• Race or ethnicity. Asian Americans are more likely than other groups to have high LDL, and non-Hispanic White people more likely to have high total cholesterol.

Lowering cholesterol

Start with heart-healthy lifestyle changes: a heart-healthy eating plan, weight management and regular physical activity. If that is not enough, you may need medicine — there are several types, including statins — and you should keep up the lifestyle changes while you take it.

Sources

Based on "Cholesterol Levels: What You Need to Know," MedlinePlus, National Library of Medicine, with its summary from the National Heart, Lung, and Blood Institute, National Institutes of Health; a work of the United States government in the public domain.