Medically reviewed by Rosanna Sutherby, PharmD on April 10, 2021. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
Cholesterol is a waxy, fat-like substance commonly found in animal-based foods like eggs, milk, and meat. It may not be much in its physical form, but cholesterol is an important health marker, playing a key role in some basic bodily functions.
Your body needs cholesterol to build cells, synthesize some vitamins, and produce certain hormones. It’s also used in the production of bile.
However, too much cholesterol can increase your risk of serious health issues. If you’re interested in learning about what causes high cholesterol, we’ve written about that in detail. For now, keep reading to learn more about high cholesterol, what symptoms to look out for, and whether taking a cholesterol test may be a good idea.
Cholesterol is carried through the blood by a type of protein called lipoprotein. Cholesterol comes in two forms based on the type of lipoprotein that carries it. Low-density lipoprotein (LDL) comprises most of the cholesterol in your body. It is often considered the “bad” cholesterol because too much of it can contribute to the accumulation of plaque in your arteries. This can increase your risk of heart attack, stroke, and peripheral artery disease.
High-density lipoprotein (HDL) cholesterol absorbs LDL cholesterol from the arteries and transports it to the liver. The liver breaks down the LDL and flushes it from the body. This is why HDL is considered the “good” cholesterol.
Ideally, you want high HDL cholesterol levels and low LDL cholesterol levels. When most physicians and experts refer to “high cholesterol,” they usually mean high LDL cholesterol.
Triglycerides are the most common type of fat found in the human body. Essentially, when you consume more calories than you use, the excess calories are stored in triglycerides. When you need extra energy between meals, your body dips into your triglycerides and burns them for fuel.
Triglycerides add an extra layer of complexity to the cholesterol issue. High LDL cholesterol and high triglyceride levels pose a significant problem as they both dramatically increase your risk of heart attack, stroke, and other cardiovascular issues.
High cholesterol levels do not actually present with any symptoms. Outside of tests, you only know that you have a high cholesterol level during emergency events. As your LDL cholesterol increases, it can combine with triglycerides, calcium, and other substances in your blood to form plaque. As plaques build up in the arteries (a process called atherosclerosis), it sticks to the arterial walls. Over time, the plaques harden, which reduces the flexibility in the arteries while narrowing the passage. This reduces or even completely blocks blood flow, which prevents oxygen and nutrients from reaching tissue and major organs.
If plaque blocks arteries that supply blood to the heart, you experience a heart attack. Plaques that block arteries leading to the brain can result in a stroke. Blocked arteries leading to the extremities can result in gangrene or mobility issues. Other potential conditions include:
Angina (chest pains caused by a reduced blood flow to the heart muscle) Carotid artery disease (reduced blood flow in the neck arteries that supply blood to the brain) Coronary heart disease (plaque in the arteries leading to the heart) Chronic kidney disease
Pieces of plaque can also break off and travel through the bloodstream before eventually sticking somewhere else that may be farther away from the heart. Plaque that does gather within an artery’s walls can potentially rupture, which leads to the formation of a thrombus, or blood clot. A blood clot in the arteries can further impede blood flow, or the clot can actually break off and circulate in the bloodstream. This free-traveling blood clot (medically known as an embolus) can be extremely dangerous, especially if it reaches the heart, lungs, or brain.
Atherosclerosis is actually a slow, lifelong process. The exact cause of it or why plaques begin to form are still not exactly known, though experts believe that plaques begin to form in response to damage to the inner lining of an artery (known as the endothelium). That damage can come from smoking, high blood pressure, and high levels of cholesterol and triglycerides in the blood.
Coronary artery disease is one of the main problems that can come from plaque buildup caused by a high blood cholesterol level. It is the most common form of heart disease in the United States, and it is sometimes referred to as coronary heart disease or ischemic heart disease.
The most common symptom of coronary artery disease is angina or chest pain. This pain results from the narrowed arteries, which prevent blood flow to the heart muscle.
For many, the first sign of coronary artery disease is a heart attack, medically known as a myocardial infarction. This occurs when part of the heart doesn’t receive enough blood. The symptoms of a heart attack can vary, but they typically include:
Over time, coronary artery disease can significantly weaken the heart, resulting in heart failure. Heart failure is a condition that impairs the heart’s ability to pump blood properly.
Your doctor can provide medication to reduce your LDL cholesterol levels. Statins are the most common drug prescribed for high blood cholesterol levels. If you have a high risk of heart attack because of cardiac risk factors, your healthcare provider may actually prescribe this type of cholesterol-lowering medication regardless of your total cholesterol levels.
Lifestyle changes can also go a long way to reducing your excess cholesterol and even potentially reversing the formation of existing plaques in the arteries.
Exercise is one of the best ways to keep your cholesterol levels balanced. Aerobic activity is known to increase your HDL levels while promoting numerous other markers of good health, including low blood pressure and reduced blood sugar levels. Just 60 minutes of moderate-intensity exercise per week is enough to have significant effects on your cholesterol.
There is no set amount of physical activity that you should do, but most experts recommend up to 150 minutes of moderate exercise per week, or about 30 minutes of exercise on most days of the week. Find something that will increase your heart rate and that is easy to sustain.
So, what exactly is a low cholesterol diet? For starters, the two most prominent diet components that can increase cholesterol are trans fats and saturated fats. Trans fats can increase LDL cholesterol while reducing HDL cholesterol. They are commonly found in foods fried foods, baked goods, and shortening. Trans fats appear to have no known health benefit, and they are considered so unhealthy that the FDA prohibits food manufacturers from adding artificial trans fats to foods and drinks.
Saturated fats are naturally found in animal-based foods, like meats and dairy products. Experts recommend limiting your saturated fat consumption to just 5 to 6% of your total daily calorie intake.
Your diet should mostly comprise fruits and vegetables, along with lean sources of protein, whole grains, and plenty of water. The amount of cholesterol in eggs is also something to consider. Consult your doctor for more personalized healthy diet information.
Smoking can lower your HDL cholesterol levels and increase your LDL cholesterol. Smoking can also cause damage to the walls of your blood vessels. This makes them more prone to developing fatty deposits and plaques. Smoking also causes permanent damage to the heart and blood vessels.
High cholesterol doesn’t show any signs or symptoms until it’s too late, which is why you should consider getting your cholesterol levels tested to find out for sure. Everlywell provides an at-home cholesterol and lipids test to help you determine your cholesterol (both HDL and LDL) and triglyceride levels. Each testing kit includes a telehealth consultation to help you go over the results and determine any next steps if necessary.