There are no symptoms of high cholesterol. Many people have never had their cholesterol checked, so they don't know they're at risk. A simple blood test can tell you your level. The good news is that there are steps you can take to prevent high cholesterol—or to reduce your levels if they are high.

Cholesterol and Your Body

Extra cholesterol can build up in your arteries. Over time, cholesterol deposits, called plaque, can narrow your arteries and allow less blood to pass through.

When plaque totally blocks an artery carrying blood to the heart, a heart attack occurs. It also can happen when a deposit ruptures and causes a clot in a coronary artery. Chest pain, also called angina, is caused by plaque partially blocking a coronary artery, reducing blood flow to the heart.

LDL and HDL: "Bad" and "Good" Cholesterol Particles called lipoproteins carry cholesterol in the blood. There are two kinds of lipoproteins you need to know about: LDL and HDL. Low-density lipoproteins (LDL) cholesterol make up the majority of the body's cholesterol. LDL is known as "bad" cholesterol because having high levels can lead to a buildup in the arteries and result in heart disease. High-density lipoproteins (HDL) cholesterol absorb cholesterol and carry it back to the liver, which flushes it from the body. High levels of HDL, or "good" cholesterol, reduce the risk of heart disease and stroke. Lowering Your Cholesterol Levels You can take several steps to maintain a normal cholesterol level. Get a blood test. Eat a healthy diet. Maintain a healthy weight. Exercise regularly. Don't smoke. Treat high cholesterol. If you have high cholesterol, your doctor may prescribe medications in addition to lifestyle changes. Talk with your doctor about how to reduce your risk for heart disease.

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Risk Factors

Some health conditions, as well as lifestyle and genetic factors, can put people at a higher risk for developing high cholesterol. However, everyone can take steps to lower their risk of high cholesterol.

Conditions

Age

Because cholesterol tends to rise as people get older, everyone's risk for high cholesterol increases with age. Women's LDL ("bad" cholesterol) levels rise more quickly than do men's. Until around age 55, women tend to have lower LDL levels than men do. At any age, men tend to have lower HDL ("good" cholesterol) levels than women do.

Diabetes

Having diabetes can also make you more likely to develop high cholesterol. Diabetes affects the body's use of a hormone called insulin. This hormone tells the body to remove sugar from the blood. With diabetes, the body either doesn't make enough insulin, can't use its own insulin as well as it should, or both. This causes sugars to build up in the blood.

Behavior

Diet Certain foods raise your cholesterol levels. These foods tend to contain saturated fats, trans fatty acids (trans fats), dietary cholesterol, or triglycerides. Saturated fats come largely from animal fat in the diet, but also from some vegetable oils such as palm oil. Trans fats come from vegetable oil that has been hardened by a process called hydrogenation. Many snack foods, fast foods, and baked goods contain trans fats. Dietary cholesterol occurs in foods that come from animal sources, including egg yolks, meat, and dairy products. Triglycerides are another type of fat in food. The body also can turn some carbohydrates into triglycerides. As with cholesterol, having high blood levels of triglycerides can raise a person's risk for heart disease. Weight Being overweight can raise LDL, lower HDL, and raise total cholesterol levels. BMI is a reliable indicator of body fatness for people. Check your BMI here. Physical Inactivity Not getting enough exercise can make you gain weight, which can lead to increased cholesterol levels.

Heredity

High cholesterol can run in families. People who have an inherited genetic condition, called familial hypercholesterolemia, have very high LDL cholesterol levels beginning at a young age.

Find out more about genetics and disease on CDC's Office of Public Health Genomics Web site.

High Blood Cholesterol Prevention

Get a Blood Test High cholesterol usually has no signs or symptoms. Only a doctor's check will reveal it. Your doctor can do a simple blood test to check your cholesterol levels. The test is called a lipoprotein profile. It measures several kinds of cholesterol as well as trigycerides. Some doctors do a simpler blood test that just checks total and HDL cholesterol. The National Cholesterol Education Program recommends that healthy adults get their cholesterol levels checked every five years.

Desirable Cholesterol Levels

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Eat a Healthy Diet

A healthy diet can help keep blood cholesterol levels down. Avoid saturated fat, trans fats, and dietary cholesterol, which tend to raise cholesterol levels. Other types of fats, such as monounsaturated and polyunsaturated fats, can actually lower blood cholesterol levels. Eating fiber can also help lower cholesterol.

For some people, eating too many carbohydrates can lower HDL (good cholesterol) and raise triglycerides. Drinking alcohol can also raise triglycerides. Too much alcohol can cause high blood pressure, which increases the risk for heart disease and stroke.

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For more information on healthy diet and nutrition, see CDC's Nutrition and Physical Activity and Obesity Program.

Maintain a Healthy Weight

Being overweight or obese can raise your bad cholesterol levels. Losing weight can help lower your cholesterol.

To determine whether your weight is in a healthy range, doctors often calculate a number called the body mass index (BMI). Doctors sometimes also use waist and hip measurements to measure a person's excess body fat.

If you know your weight and height, you can compute your BMI.

Exercise Regularly

Physical activity can help maintain a healthy weight and lower cholesterol. The Surgeon General recommends that adults should engage in moderate-intensity exercise for at least 30 minutes on most days of the week.

For more information see Fitness Fundamentals

Don't Smoke

Smoking injures blood vessels and speeds up the hardening of the arteries. Smoking greatly increases a person's risk for heart disease and stroke.

If you don't smoke, don't start. If you do smoke, quitting will lower your risk for heart disease and stroke. Your doctor can suggest programs to help you stop smoking.

Breathing secondhand smoke increases a person's risk for a heart attack and other heart conditions.

Treat High Cholesterol

If you have high cholesterol, your doctor may prescribe medications in addition to lifestyle changes. Controlling LDL cholesterol is the primary focus of treatment.

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Your treatment plan will depend on your current LDL level and risk for heart disease and stroke. Your risk for heart disease and stroke depends on other risk factors including high blood pressure, smoking status, age, HDL level, and family history of early heart disease. In addition, people with existing cardiovascular disease or diabetes are at high risk.

You can estimate your risk for heart disease by using the 10-year risk calculator of the National Cholesterol Education Program at the National Heart, Lung, and Blood Institute's Web site.

Several types of medications help lower cholesterol—

Type of Medicine	How They Work
Statin drugs	Statin drugs lower LDL cholesterol by slowing down the liver's production of cholesterol. They also increase the liver's ability to remove LDL cholesterol already in the blood.
Bile acid sequestrants	Bile acid sequestrants help remove cholesterol from the blood stream by eliminating bile acids. The body needs bile acids and makes them by breaking down LDL cholesterol.
Niacin, or nicotinic acid	Niacin is a B vitamin that can improve all lipoprotein levels. Nicotinic acid raises HDL cholesterol levels while lowering total cholesterol, LDL cholesterol, and triglyceride levels. Treatment requires high levels of niacin with possible side effects and so requires medical supervision.
Fibrates	Fibrates mainly lower triglycerides and, to a lesser extent, increase HDL levels.

All drugs may have side effects, so talk with your doctor on a regular basis. Once your cholesterol levels have improved, your doctor will want to monitor them.

Lifestyle changes are just as important as taking medicines.

CDC Addresses High Blood Cholesterol

CDC supports several public health efforts that address high blood cholesterol.

Program Name	Key Facts
	Since 1998, CDC has funded state health departments' efforts to reduce the number of people with heart disease or stroke. Health departments in 41 states and the District of Columbia currently receive funding. The program stresses policy and education to promote heart-healthy and stroke-free living and working conditions.
	WISEWOMAN helps women with little or no health insurance reduce their risk for heart disease, stroke, and other chronic diseases. The program assists women age 40 to 64 in improving their diet, physical activity, and other behaviors. WISEWOMAN also provides cholesterol tests and other screening. The CDC funds 21 WISEWOMAN projects in 19 states and two tribal organizations.
A Public Health Action Plan to Prevent Heart Disease and Stroke	The Action Plan charts a national course to prevent heart disease and stroke. The National Forum for Heart Disease and Stroke Prevention implements the Action Plan. The Forum consists of representatives of public and private health care, along with faith, advocacy, academic, and policy organizations.
	Healthy People 2010, the federal government's agenda for building a healthier nation, includes 16 objectives specific to heart disease and stroke. CDC leads the heart disease and stroke programs along with the National Heart, Lung, and Blood Institute. In 2007, researchers assessed the strategies, challenges, and successes of the heart disease initiatives. Healthy People 2010 will take into account changing trends and priorities in public health.
	CDC's Environmental Health Laboratory serves as the world reference laboratory for measuring cholesterol, triglycerides, high-density lipoproteins, and low-density lipoproteins. The laboratory helps to ensure the quality of about 35 million cholesterol measurements made annually in the United States. Doctors require accurate measurements to diagnose and properly treat people with high cholesterol levels.