Cholesterol is a waxy, fat-like substance your body needs to build cells and produce hormones. However, too much cholesterol in your blood—especially LDL cholesterol—can increase your risk of heart disease and stroke.

High cholesterol usually has no symptoms. A blood test can help identify unhealthy levels before complications develop.

LDL vs. HDL: What’s the Difference?

Cholesterol travels through your bloodstream in particles called lipoproteins.

• LDL cholesterol: Often called “bad” cholesterol because high levels contribute to plaque buildup in the arteries
• HDL cholesterol: Often called “good” cholesterol because it helps transport cholesterol back to the liver for removal

A higher HDL level does not offset the risks of high LDL. Your provider considers your full cholesterol profile and overall cardiovascular risk.

Triglycerides are another type of fat measured during cholesterol testing. Elevated triglycerides can also contribute to cardiovascular risk.

Know About Cholesterol 

Lipoproteins carry cholesterol in the bloodstream, which comprises proteins and fats. There are two types of lipoproteins, including:

• Low-density lipoprotein (LDL)
• high-density lipoprotein (HDL)

DL cholesterol, commonly referred to as "bad" cholesterol, can accumulate on the walls of arteries and increase the likelihood of heart disease and stroke. Conversely, HDL cholesterol, known as "good" cholesterol, aids in eliminating excess cholesterol from the bloodstream and offers protection against heart diseases, including attacks and strokes.

Why High Cholesterol Matters

Excess LDL cholesterol can contribute to atherosclerosis, the buildup of plaque that narrows and hardens arteries. Plaque can restrict blood flow or rupture, triggering a blood clot.

This increases the risk of:

• Coronary artery disease, which may cause chest discomfort known as angina
• Heart attack
• Stroke
• Peripheral artery disease, which affects circulation, commonly in the legs

Lowering LDL cholesterol helps reduce these risks.

What Causes High Cholesterol?

Cholesterol levels reflect a combination of genetics, lifestyle and health conditions. Contributing factors include:

• Diet: Frequent consumption of foods high in saturated or trans fats
• Limited physical activity
• Overweight or obesity
• Smoking: Can lower HDL and damage blood vessels
• Health conditions: including diabetes, an underactive thyroid, or kidney disease
• Certain medications
• Inherited conditions: Such as familial hypercholesterolemia

People with inherited high cholesterol may need medication even if they eat well and stay active. High cholesterol is not always due to lifestyle choices.

How Is High Cholesterol Diagnosed?

A blood test called a lipid panel measures:

• Total cholesterol
• LDL cholesterol
• HDL cholesterol
• Triglycerides

Some tests require fasting; others do not. Follow your provider’s instructions.

Your provider interprets the results in the context of your age, blood pressure, family history, diabetes status, and other risk factors. Your LDL goal depends on your individual risk, not merely whether total cholesterol falls within a general reference range.

Ask how often you should be tested, especially if you have a family history of high cholesterol or of early heart disease.

How to Manage High Cholesterol

Heart-Healthy Habits

• Reduce saturated fat: Limit fatty meats, butter and full-fat dairy
• Choose unsaturated fats: Use foods such as olive oil, nuts, and seeds in appropriate portions
• Add fiber-rich foods: Include oats, beans, lentils, fruit and vegetables
• Stay active: Choose regular physical activity appropriate for your health
• Manage weight: Gradual weight loss may help if you are overweight
• Quit smoking and limit alcohol

Cholesterol-Lowering Medication

Lifestyle changes may not lower cholesterol enough on their own. Your provider may recommend:

• Statins: Reduce cholesterol production in the liver and help lower the risk of heart attack and stroke
• Other medicines: Such as ezetimibe, bempedoic acid or injectable treatments, depending on your needs

Take medication as prescribed and keep your follow-up appointments. If you experience side effects, discuss them with your provider rather than stopping treatment on your own.

Take the Next Step for Your Heart Health

Concerned about high cholesterol or unsure what your results mean? Schedule a visit with tru Primary & Urgent Care to discuss testing, cardiovascular risk, and treatment options.