High Cholesterol

(Cholesterol, High; Hypercholesterolemia)




Cholesterol is a type of lipid in the blood. High cholesterol is an abnormally high level of cholesterol in the blood.

There are different types of cholesterol in your blood including:

  • Low density lipoproteins (LDL)—causes build up of cholesterol and other fats in the blood vessels. Known as bad cholesterol because high levels can cause disease in the arteries and heart disease.
  • High density lipoproteins (HDL)—can remove cholesterol and other fats from the blood. Known as good cholesterol because it may protect against heart disease.



Causes of high cholesterol include:

  • Genetics
  • High-fat diet
  • Overweight
  • Sedentary lifestyle

Risk Factors

Risk Factors

The risk of high cholesterol increases with age. It is more common in men. It is also more common in women after menopause.

Factors that may increase your risk of high cholesterol include:

  • Family members with high cholesterol
  • High-fat diet
  • Obesity, overweight
  • Sedentary lifestyle



It is rare for high cholesterol to cause symptoms. However, high cholesterol can increase your risk of atherosclerosis. This is a dangerous hardening of the arteries. It can block the flow of blood. Some complications of atherosclerosis include:

Some people with high cholesterol may also have cholesterol deposits in tendons, under the eyes, or in the eye.


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You will be asked about your symptoms and medical history. A physical exam will be done. You will be asked about factors that may increase your risk of heart disease or stroke.

A blood test will also be done. Blood will be sent to a lab to measure lipid levels in your blood. Tests may include:

  • Total cholesterol
  • HDL cholesterol
  • LDL cholesterol
  • Triglycerides

Other tests may be done to look for other conditions that can be associated with high cholesterol levels.



Talk to your doctor about the best treatment plan for you. Treatment is aimed at decreasing your LDL cholesterol levels and decreasing your risk for heart disease and stroke. Options include:

Nutritional Changes

Talk to your doctor about the best meal plan for you. Consider the following changes:

  • Balance the amount of calories you are eating with the amount of calories you use through physical activity and basic body functions. This will help you reach or maintain a healthy weight.
  • Eat a diet that is high in fruits and vegetables.
  • Include foods that are whole grain and high in fiber.
  • Eat fish at least twice per week.
  • Limit foods with saturated fats, trans fats, or cholesterol.
  • Avoid processed and refined sugars and starches. This includes white bread, white potatoes, white rice, and simple sugars like soda.
  • Choose and prepare foods with little or no salt.
  • Consider drinking green or black tea, which have been shown to help reduce cholesterol.
  • If you drink alcohol, drink in moderation.

Lifestyle Changes

  • Begin a safe exercise program with the advice of your doctor.
  • If you smoke, talk to your doctor about ways to quit.
  • If you are overweight, talk to your doctor about ways to lose weight.
  • Make sure other medical conditions, such as high blood pressure and diabetes, are being treated and controlled.

Cholesterol-Lowering Medication

You may be prescribed statins to help lower your cholesterol. Statins have been shown to reduce mortality, heart attacks, and stroke.

These medications are best used as additions to diet and exercise. They should not be use in place of healthy lifestyle changes.



To help reduce your chance of getting high cholesterol, follow the lifestyle and nutrition changes above.


American Heart Association http://www.heart.org

National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov


Canadian Cardiovascular Society http://www.ccs.ca

Heart and Stroke Foundation of Canada http://www.heartandstroke.com


Cholesterol. American Heart Association website. Available at:
Accessed January 26, 2015.

Hypercholesterolemia. EBSCO DynaMed website. Available at:
Updated December 31, 2014. Accessed January 26, 2015.

Lipid-lowering pharmacotherapy overview. EBSCO DynaMed website. Available at:
Updated December 18, 2014. Accessed January 26, 2015.

Third report of the expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). National Cholesterol Education Program website. Available at:
Updated 2004. Accessed January 26, 2015.

What is cholesterol? National Heart, Lung, and Blood Institute website. Available at:
Updated September 19, 2012. Accessed January 26, 2015.

12/14/2009 DynaMed’s Systematic Literature Surveillance
Ferdowsian HR, Barnard ND. Effects of plant-based diets on plasma lipids. Am J Cardiol. 2009;104(7):947-956.

8/27/2013 DynaMed’s Systematic Literature Surveillance
Hartley L, Flowers N, Holmes J, et al. Green and black tea for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013 Jun 18;6:CD009934.

Last reviewed January 2015 by Marcin Chwistek, MD
Last Updated: 5/1/2014

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