Prevention and Treatment of High Cholesterol (Hyperlipidemia)

Know your numbers. And what to do about them.

When it comes to cholesterol, it's important to know your numbers. Hyperlipidemia means your blood has too many lipids (or fats), such as cholesterol and triglycerides. One type of hyperlipidemia, hypercholesterolemia, means you have too much non-HDL cholesterol and LDL (bad) cholesterol in your blood. This condition increases fatty deposits in arteries and the risk of blockages.

Another way your cholesterol numbers can be out of balance is when your HDL (good) cholesterol level is too low. With less HDL to remove cholesterol from your arteries, your risk of atherosclerotic plaque and blockages increases. Atherosclerotic cardiovascular disease (ASCVD) involves plaque buildup in arterial walls which includes conditions such as acute coronary syndrome and peripheral artery disease, and can cause a heart attack, stable or unstable angina, stroke, transient ischemic attack (TIA) or aortic aneurysm.

Download Reduce Your Risk of ASCVD (PDF)

If you’re diagnosed with hyperlipidemia, your overall health and other risks such as smoking or high blood pressure will help guide treatment. These factors can combine with high LDL cholesterol or low HDL cholesterol levels to affect your cardiovascular health. Your doctor may use the ASCVD Risk Calculator to assess your risk of a coronary event in the next 10 years.

The good news is, high cholesterol can be lowered, reducing risk of heart disease and stroke. If you’re 20 years or older, have your cholesterol tested and work with your doctor to adjust your cholesterol levels as needed.

Often, changing behaviors can help bring your numbers into line. If lifestyle changes alone don’t improve your cholesterol levels, medication may be prescribed. Lifestyle changes include:

Eating a heart-healthy diet

From a dietary standpoint, the best way to lower your cholesterol is reduce your intake of saturated fat and trans fat. The American Heart Association recommends limiting saturated fat to less than 6% of daily calories and minimizing the amount of trans fat you eat.

Reducing these fats means limiting your intake of red meat and dairy products made with whole milk. Choose skim milk, low-fat or fat-free dairy products instead. It also means limiting fried food and cooking with healthy oils, such as vegetable oil.

A heart-healthy diet emphasizes fruits, vegetables, whole grains, poultry, fish, nuts and nontropical vegetable oils, while limiting red and processed meats, sodium and sugar-sweetened foods and beverages.

Many diets fit this general description. For example, the DASH (Dietary Approaches to Stop Hypertension) eating plan promoted by the National Heart, Lung, and Blood Institute as well as diets suggested by the U.S. Department of Agriculture and the American Heart Association are heart-healthy approaches. Such diets can be adapted based on your cultural and food preferences.

To be smarter about what you eat, pay more attention to food labels. As a starting point:

• Know your fats. Knowing which fats raise LDL cholesterol and which ones don’t is key to lowering your risk of heart disease.
• Cook for lower cholesterol. A heart-healthy eating plan can help you manage your blood cholesterol level.

Becoming more physically active

A sedentary lifestyle lowers HDL cholesterol. Less HDL means there’s less good cholesterol to remove bad cholesterol from your arteries.

Physical activity is important. At least 150 minutes of moderate-intensity aerobic exercise a week is enough to lower both cholesterol and high blood pressure. And you have lots of options: brisk walking, swimming, bicycling or even yard work can fit the bill.

Learn more about getting active.

Quitting smoking

Smoking and vaping lowers HDL cholesterol.

Worse still, when a person with unhealthy cholesterol levels also smokes, risk of coronary heart disease increases more than it otherwise would. Smoking also compounds the risk from other risk factors for heart disease, such as high blood pressure and diabetes.

By quitting, smokers can lower their LDL cholesterol and increase their HDL cholesterol levels. It can also help protect their arteries. Nonsmokers should avoid exposure to secondhand smoke.

Learn more about quitting smoking.

Losing weight

Being overweight or obese tends to raise bad cholesterol and lower good cholesterol. But a weight loss of as little as 5% to 10% can help improve cholesterol numbers.

Learn more about losing weight.

Thoughtful Talks with My Health Care Professional: My Cholesterol Treatment Plan

Your health care professional can help you reach your health goals, including keeping your cholesterol at healthy levels.

Making decisions with your health care team is the best way to create a treatment plan you’ll be more likely to stick to. If you don’t understand something, ask for further clarification.

Here’s a helpful checklist (PDF) that you and your health care professional can go through to determine your risk and the best treatment options for you.