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Frequently Asked Questions

What is high cholesterol?

Short Answer

High cholesterol is an excess of fatty substances in the blood.

Long Answer

Cholesterol is an essential fat used to create cell membranes, hormones, and Vitamin D. The liver produces most of the body's cholesterol and releases it into the bloodstream where it is absorbed by the tissues that need it. All the body's cholesterol needs can be met by what is produced by the liver.

Cholesterol consumed in food adds to the amount in the blood. When cholesterol levels in the bloodstream are too high, it's called hypercholesterolemia. Over time, fatty deposits can accumulate inside the artery walls resulting in a condition called atherosclerosis - narrowing and hardening of the arteries. This, in turn, can lead to serious health conditions such as a heart attack or stroke.

Illustration of an artery affected by atherosclerosis

There are no symptoms of high cholesterol itself except in rare cases when extremely high cholesterol causes yellow patches to form in the skin above the eyelids. Getting your cholesterol levels tested can identify whether levels are elevated so you can make changes to reduce your blood cholesterol.

Good and Bad Cholesterol

You've probably heard of "good" and "bad" cholesterol. Both perform essential functions but when bad cholesterol levels rise too much in comparison with good cholesterol, it can cause problems. Both types are a combination of cholesterol, protein, and other substances.

Low-density lipoprotein (LDL) cholesterol
LDL delivers cholesterol to the cells that need it. However, when LDL levels become too high, some of it collects inside artery walls forming a hard plaque which is how atherosclerosis begins. This is why it's called bad cholesterol.
High-density lipoprotein (HDL) cholesterol
This is the good cholesterol. HDL acts as the clean-up crew by picking up unused cholesterol from artery walls and returning it to the liver where it's eliminated. When LDL levels become too high, HDL can't keep up with its clean-up duties and atherosclerosis results.

How cholesterol interacts inside arteries

Measuring Cholesterol Levels

There are a number of blood tests that can be performed to check cholesterol levels including one that measures LDL levels only and one that measures total cholesterol and HDL.

The most comprehensive test for checking cholesterol levels is a lipoprotein (or lipid) profile. You'll be asked to fast for nine to 12 hours without food, liquids, and medications before your blood is drawn. This test measures the following four components:

Total Cholesterol
This measures the total amount of cholesterol in your blood found in LDL, HDL, and another type of lipoprotein called VLDL (very low-density lipoprotein).
High levels of LDL increase your chance of developing atherosclerosis which can narrow and block the arteries and result in a heart attack or stroke.
High levels of HDL provide some protection against heart disease and stroke while levels that are too low can increase the risk.
Triglycerides are a type of fat found in the blood. When the calories you consume in food are not immediately needed for energy, it's converted to triglycerides and stored in the body's fat cells. High levels of triglycerides increase the risk of heart disease, especially in women.

You can use one of the two tables below to check your cholesterol test results. There are different units used for measuring blood cholesterol, depending on what country you're in:

  • mg/dL - milligrams (mg) of cholesterol per deciliter (dL) of blood in the United States and some other countries
  • mmol/L - millimoles (mmol) per liter (L) of blood in Canada and most European countries
U.S. and some other countries (mg/dL)
  Desirable or Optimal Near Optimal Borderline High High or Poor Very High
Total Cholesterol < 200 - 200 - 239 240+ -
LDL < 100 100 - 129 130 - 159 160 - 189 190+
HDL 60+ 40 - 59 - < 40 -
Triglycerides < 150 - 150 - 199 200 - 499 500+
Canada and most of Europe (mmol/L)
  Desirable or Optimal Near Optimal Borderline High High or Poor Very High
Total Cholesterol < 5.2 - 5.2 - 6.2 6.2+ -
LDL < 2.6 2.6 - 3.3 3.4 - 4.1 4.1 - 4.9 5.0+
HDL 1.6+ 1 - 1.5 - < 1 -
Triglycerides < 1.7 - 1.7 - 2.2 2.3 - 5.6 5.6+

Risk Factors

  • Being overweight
  • Not getting enough exercise
  • Family history of heart disease or high cholesterol
  • High blood pressure
  • Cigarette smoking
  • A diet high in saturated fat and trans fat.
  • Age: risk increases for men over 45 and women over 55.
  • Diabetes
  • Hypothyroidism


Statins are commonly prescribed to treat high cholesterol. They work in the liver to reduce production of LDL cholesterol. The following drugs are examples of statins:

Lifestyle Changes

A healthy lifestyle can significantly improve blood cholesterol levels. All of the measures in the illustration below will help increase HDL levels. A healthy diet and regular, sustained exercise reduces LDL levels.

Lifestyle changes to improve blood cholesterol levels

Additional Information

The University of Maryland Medical Center web page contains a wealth of information in addition to the basics of high cholesterol such as dietary recommendations, nutrition and dietary supplements, herbs, and other health considerations.
The American Heart Association has extensive information about cholesterol and related conditions. There are links to articles about the new cholesterol guidelines published by the American Heart Association and American College of Cardiology and various tools and resources. The interactive library contains great illustrations and animations to help you better understand cholesterol.
What's the difference between LDL and HDL cholesterol?
This is a down-to-earth article that explains cholesterol.