8/26/2015

Patient information: High cholesterol (The Basics)

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Patientinformation:Highcholesterol(TheBasics)
WrittenbythedoctorsandeditorsatUpToDate
Whatischolesterol?Cholesterolisasubstancethatisfoundintheblood.Everyonehassome.Itisneededforgoodhealth.Theproblemis,people
sometimeshavetoomuchcholesterol.Comparedwithpeoplewithnormalcholesterol,peoplewithhighcholesterolhaveahigherriskofheartattacks,strokes,
andotherhealthproblems.Thehigheryourcholesterol,thehigheryourriskoftheseproblems.
Aretheredifferenttypesofcholesterol?Yes,thereareafewdifferenttypes.Ifyougetacholesteroltest,youmighthearyourdoctorornursetalkabout:
Totalcholesterol
LDLcholesterolSomepeoplecallthisthebadcholesterol.ThatsbecausehavinghighLDLlevelsraisesyourriskofheartattacks,strokes,andother
healthproblems.
HDLcholesterolSomepeoplecallthisthegoodcholesterol.ThatsbecausehavinghighHDLlevelslowersyourriskofheartattacks,strokes,and
otherhealthproblems.
NonHDLcholesterolNonHDLcholesterolisyourtotalcholesterolminusyourHDLcholesterol.
TriglyceridesTriglyceridesarenotcholesterol.Theyareatypeoffat.Buttheyoftengetmeasuredwhencholesterolismeasured.(Havinghigh
triglyceridesalsoseemstoincreasetheriskofheartattacksandstrokes.)
Whatshouldmynumbersbe?Askyourdoctorornursewhatyournumbersshouldbe.Differentpeopleneeddifferentgoals.(IfyouliveoutsidetheUnited
States,seetheTable(table1)).Ingeneral,peoplewhodonotalreadyhaveheartdiseaseshouldaimfor:

Totalcholesterolbelow200
LDLcholesterolbelow130ormuchlower,iftheyareatriskofheartattacksorstrokes
HDLcholesterolabove60
NonHDLcholesterolbelow160orlower,iftheyareatriskofheartattacksorstrokes
Triglyceridesbelow150

Keepinmind,though,thatmanypeoplewhocannotmeetthesegoalsstillhavealowriskofheartattacksandstrokes.
WhatshouldIdoifmydoctortellsmeIhavehighcholesterol?Askyourdoctorwhatyouroverallriskofheartattacksandstrokesis.Highcholesterol,
byitself,isnotalwaysareasontoworry.Havinghighcholesterolisjustoneofmanythingsthatcanincreaseyourriskofheartattacksandstrokes.Other
factorsthatincreaseyourriskinclude:
Cigarettesmoking
Highbloodpressure
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Patient information: High cholesterol (The Basics)

Havingaparent,sister,orbrotherwhogotheartdiseaseatayoungage(Young,inthiscase,meansyoungerthan55formenandyoungerthan65for
women.)
Beingaman(Womenareatrisk,too,butmenhaveahigherrisk.)
Olderage
Ifyouareathighriskofheartattacksandstrokes,havinghighcholesterolisaproblem.Ontheotherhand,ifyouareatlowrisk,havinghighcholesterolmight
notmeanmuch.
ShouldItakemedicinetolowercholesterol?Noteveryonewhohashighcholesterolneedsmedicines.Yourdoctorornursewilldecideifyouneedthem
basedonyourage,familyhistory,andotherhealthconcerns.
Youshouldprobablytakeacholesterolloweringmedicinecalledastatinifyou:

Alreadyhadaheartattackorstroke
Haveknownheartdisease
Havediabetes
Haveaconditioncalledperipheralarterydisease,whichmakesitpainfultowalk,andhappenswhenthearteriesinyourlegsgetcloggedwithfatty
deposits
Haveanabdominalaorticaneurysm,whichisawideningofthemainarteryinthebelly
Mostpeoplewithanyoftheconditionslistedaboveshouldtakeastatinnomatterwhattheircholesterollevelis.Ifyourdoctorornurseputsyouonastatin,stay
onit.Themedicinemightnotmakeyoufeelanydifferent.Butitcanhelppreventheartattacks,strokes,anddeath.
CanIlowermycholesterolwithoutmedicines?Yes,youcanloweryourcholesterolsomeby:
Avoidingredmeat,butter,friedfoods,cheese,andotherfoodsthathavealotofsaturatedfat
Losingweight(ifyouareoverweight)
Beingmoreactive
Evenifthesestepsdolittletochangeyourcholesterol,theycanimproveyourhealthinmanyways.
Moreonthistopic
Patientinformation:Familialhypercholesterolemia(TheBasics)
Patientinformation:Atherosclerosis(TheBasics)
Patientinformation:Coronaryheartdisease(TheBasics)
Patientinformation:Stroke(TheBasics)
Patientinformation:Reducingthecostsofmedicines(TheBasics)
Patientinformation:Brandversusgenericmedicines(TheBasics)
Patientinformation:Sideeffectsfrommedicines(TheBasics)
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Patient information: High cholesterol (The Basics)

Patientinformation:Hightriglycerides(TheBasics)
Patientinformation:Canfoodsorsupplementslowercholesterol?(TheBasics)
Patientinformation:Highcholesterolandlipids(hyperlipidemia)(BeyondtheBasics)
Patientinformation:Highcholesteroltreatmentoptions(BeyondtheBasics)
Patientinformation:Reducingthecostsofmedicines(BeyondtheBasics)
Alltopicsareupdatedasnewevidencebecomesavailableandourpeerreviewprocessiscomplete.
ThistopicretrievedfromUpToDateon:Aug26,2015.
ThecontentontheUpToDatewebsiteisnotintendednorrecommendedasasubstituteformedicaladvice,diagnosis,ortreatment.Alwaysseektheadviceof
yourownphysicianorotherqualifiedhealthcareprofessionalregardinganymedicalquestionsorconditions.TheuseofUpToDatecontentisgovernedbythe
UpToDateTermsofUse.2015UpToDate,Inc.Allrightsreserved.
Topic15330Version12.0

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Patient information: High cholesterol (The Basics)

GRAPHICS
CholesterolandtriglyceridemeasurementsintheUnitedStatesandelsewhere

Total

MeasurementusedwithintheUnited
States
Milligrams/deciliter(mg/dL)

MeasurementusedmostplacesoutsidetheUnited
States
Millimoles/liter(mmol/Liter)

Leveltoaimfor

Leveltoaimfor

Below200

Below5.17

LDL
cholesterol

Below130ormuchlowerifatriskofheartattack
andstroke

Below3.36ormuchlowerifatriskofheartattackandstroke

HDL
cholesterol

Above60

Above1.55

Triglycerides

Below150

Below1.7

cholesterol

CholesterolismeasureddifferentlyintheUnitedStatesthanitisinmostothercountries.Thistableshowsvaluesusedwithinandoutside
theUnitedStates.Itincludesthecholesterolandtriglyceridelevelsthatmostpeoplewhodonothaveheartdiseaseshouldaimfor.
Graphic76734Version2.0

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