Why is it important to have a normal cholesterol level?

A high cholesterol level can increase your risk of having a heart attack or stroke. You have an even higher risk if you also have other risk factors, such as:

• Age over 45 for men and over 55 for women

• Smoking

• Diabetes

• Obesity/overweight

• Physical inactivity

• High blood pressure

• A history of heart disease in your father or a brother before he was 55 years of age or in your mother or a sister before she was 65 years of age

• A low HDL cholesterol level

What does the term “total cholesterol” mean?

The term “total cholesterol” refers to the total amount of the different kinds of cholesterol in your blood. One kind of cholesterol is the LDL cholesterol. Another kind is the HDL cholesterol. “LDL” stands for low-density lipoprotein. LDL is the “bad” cholesterol. “HDL” stands for high-density lipoprotein. HDL is the “good” cholesterol.

Why is LDL called the “bad” cholesterol?

LDL is called the “bad” cholesterol because it can cause a buildup of fat and cholesterol in the walls of your blood vessels. If your LDL has been high for many years, this buildup can clog the arteries to your heart or brain. The arteries may be partly or totally blocked. The medical word for this blockage is “atherosclerosis.” Clogged arteries to the heart can cause a heart attack. Clogged arteries to the brain can cause a stroke.

What are normal cholesterol levels?

A normal total cholesterol level is less than 200. A normal LDL level is less than 130. A normal HDL level is higher than 35.

A high HDL level is better. An HDL level higher than 60 is the best. HDL is called the “good” cholesterol because it helps remove cholesterol from your body. In this way, HDL helps prevent heart disease and stroke. Regular exercise is a good way to increase your HDL level.

If your total cholesterol level is 200 to 239, you have a borderline level. The word “borderline” is used because levels of 200 to 239 are close to being high. A total cholesterol of 240 or above is a high level.

If your LDL level is 130 to 159, you have a borderline level. If your LDL level is 160 or higher, you have a high level.

What should my LDL level be?

It depends. If you don't have heart disease, your goal would be to lower your LDL level to less than 130. If you do have heart disease, your goal would be to reduce your LDL level to less than 100. But even if you don't have heart disease, it's better to get your LDL level as low as you can.

How can I reduce my LDL and total cholesterol levels?

Eating a low-fat, heart-healthy diet is a good start. Try not to eat fatty cuts of beef and pork. Eat more chicken, turkey and fish. Drink fatfree milk instead of whole milk. Avoid other high-fat dairy foods like cheese, butter and ice cream. Avoid fried foods. Eat lots of fresh fruits and vegetables.

What about taking a drug to reduce my cholesterol level?

If you stay on a low-fat diet for three to six months but still have not reached your goal, talk to your doctor about taking a medicine to reduce your cholesterol level.

When you take a cholesterol-lowering medicine, try to take it every day at about the same time. The drop in your cholesterol level caused by the drug lasts only one or two days after you stop taking the medicine.

Be sure to tell your doctor about any changes in your body that might be a side effect from the medicine. Also, talk to your doctor if you are worried about taking the medicine.

If the cholesterol medicine does not help reduce your LDL level enough after several months of treatment, your doctor may increase the dose. Changing to a different cholesterol medicine can also help.

Another way to make the cholesterol medicine work would be to add a second medicine to your treatment. Your doctor can try different treatments to find which one works for you. Even if you are taking a medicine to lower your cholesterol, it's still important to follow a heart-healthy diet.

Where can I find more information about the treatment of high cholesterol?

Ask your doctor where you can find information on cholesterol. Your library may have books on high cholesterol and heart disease. The Web sites of the National Heart, Lung, and Blood Institute and the American Heart Association have good information. Their addresses are http://www.nhlbi.nih.gov and http://www.americanheart.org.