The National Cholesterol Education Program (NCEP) sponsors National Cholesterol Education Month every September to increase awareness of the importance of monitoring cholesterol levels and taking steps to achieve or maintain healthy levels. Cholesterol is a crucial substance in the body, but when its levels become unbalanced, it can lead to serious health issues. Understanding the different types of cholesterol, how they affect your health, and how to manage them is essential to maintaining cardiovascular health.
What is Cholesterol?
Cholesterol is a waxy, fat-like substance found in your blood. Your body needs cholesterol to build healthy cells, does not need cholesterol from food, and can naturally manufacture it. The liver naturally produces cholesterol, a fatty substance that helps the body make hormones and digest fatty foods. However, there is also cholesterol in animal-based foods, such as the bacon, cheese, butter, and eggs we all love and consume, and may impact our cholesterol numbers.
The types of lipoproteins transporting cholesterol and triglycerides through the bloodstream to cells in the body are:
Low-density lipoprotein (LDL): Often referred to as "bad" cholesterol, LDL can build up on the walls of your arteries, forming plaque that narrows and hardens them. This can lead to atherosclerosis, increasing the risk of heart attack, stroke, and other cardiovascular diseases.
High-Density Lipoprotein (HDL): Known as "good" cholesterol, HDL helps remove LDL cholesterol from the bloodstream by transporting it to the liver for elimination. Higher levels of HDL are associated with a lower risk of heart disease.
Very Low-Density Lipoprotein (VLDL): This “bad” lipoprotein primarily carries triglycerides, another type of fat, in the blood. Like LDL, high levels of VLDL can contribute to plaque buildup in the arteries.
Lipoprotein(a), (Lp(a)): Another lipoprotein in the “bad” category, Lp(a), is similar to LDL but includes an additional protein called apolipoprotein(a). High levels of Lp(a) are considered a risk factor for atherosclerosis, heart attack, and stroke, even if your overall cholesterol levels are within a normal range. Unlike other types of cholesterol, Lp(a) levels are largely determined by genetics and are not significantly influenced by diet or lifestyle changes. Standard cholesterol blood tests don't usually test for Lp(a). While there are currently no FDA-approved therapies for lowering Lp(a) levels, four promising investigational therapies are in clinical trials.
Recommended Cholesterol Levels
The American Heart Association (AHA) provides guidelines for optimal cholesterol levels:
Total Cholesterol: Less than 200 mg/dL
LDL Cholesterol: Less than 100 mg/dL (optimal); 100-129 mg/dL (near optimal)
HDL Cholesterol: 60 mg/dL or higher (optimal)
Triglycerides: Less than 150 mg/dL
These ranges can vary depending on individual health conditions, such as a history of heart disease or diabetes, where stricter targets might be recommended. It is best to review these numbers with your physician to assess potential health risks and whether lifestyle changes or medications may be needed to manage the levels.
Frequency of Cholesterol Testing
When and how often you should get a cholesterol test depends on your age, risk factors, and family history. The general recommendations are:
For people who are age 19 or younger:
The first test should be between ages 9 to 11
Children should have the test again every five years
Some children may have this test starting at age two if there is a family history of high cholesterol, heart attack, or stroke
For people who are ages 20 to 65:
Younger adults should have the test every five years
Men aged 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years
For people older than 65:
They should be tested every year
The Risks of High Cholesterol
High cholesterol levels, particularly high LDL, can lead to the buildup of plaque in the arteries, a condition known as atherosclerosis. This can reduce or block blood flow, leading to chest pain (angina), heart attack, or stroke. High cholesterol is also associated with peripheral artery disease and an increased risk of developing coronary artery disease.
What Affects My Cholesterol Levels?
Many factors can affect your cholesterol levels, many of which can be controlled:
Diet. Saturated fat and cholesterol in your food make your blood cholesterol level rise. Saturated fat is the main problem, but cholesterol in foods also matters. Reducing the amount of saturated fat in your diet helps lower your blood cholesterol level. Foods with high levels of saturated fats include red meats, full-fat dairy products, chocolate, some baked goods, and deep-fried and processed foods.
Weight. Being overweight or obese is a risk factor for heart disease. They also tend to increase your cholesterol.
Lack of physical activity. Not being physically active is a risk factor for heart disease.
Smoking. Cigarette smoking lowers your HDL cholesterol. Since HDL helps to remove cholesterol from your arteries, having a lower HDL level can contribute to a higher cholesterol level.
Some factors that you cannot change can also affect cholesterol levels, such as:
Gender. Between ages 20 and 39, men have a greater risk of high total cholesterol than women. But after menopause, a woman's risk goes up. This happens because menopause lowers levels of female hormones that may protect against high blood cholesterol.
Family history. Your genes partly determine how much cholesterol your body makes. High cholesterol can run in families.
Race or ethnicity. People from particular racial or ethnic groups may have an increased risk of high cholesterol. For example, Asian Americans are more likely to have high levels of LDL cholesterol than other groups. And non-Hispanic White people are more likely than other groups to have high levels of total cholesterol.
Age. Cholesterol levels often increase with age due to metabolic changes and lifestyle factors. As the body ages, it becomes less efficient at processing and removing cholesterol from the bloodstream, leading to higher levels of LDL (bad cholesterol) and, in some cases, a decrease in HDL (good cholesterol). Hormonal changes, particularly in women during and after menopause, can also contribute to higher cholesterol levels. Additionally, older adults may experience reduced physical activity and dietary changes, such as increased consumption of cholesterol-raising foods, which can further elevate cholesterol levels. Regular monitoring and proactive management become increasingly important as cholesterol levels naturally rise with age. Regularly monitoring cholesterol levels is crucial, particularly as you age, to manage the risk of heart disease.
National Cholesterol Education Month allows you to take charge of your heart health. By understanding the different types of cholesterol and their impact on your body, you can take proactive steps to manage your cholesterol levels and reduce the risk of heart disease.
ACLS Academy is an authorized American Heart Association (AHA)- Aligned Training Center. We have three convenient locations in Massachusetts—Quincy, Bridgewater, and Newton Center—and most of our classes include an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, PALS Plus, PEARS and Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.