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Your Guide to Lowering High Cholesterol

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LDL Cholesterol: What It Is, Health Risks, and Lowering Levels

Medically Reviewed By Megan Soliman, MD

Low-density lipoprotein (LDL) cholesterol is also known as “bad” cholesterol. LDL is a fat that can buildup in the arteries. Treatment can include medication and diet changes. LDL can be helpful to the body in some amounts, but high levels of LDL can affect cardiovascular health. Medication and lifestyle changes can lower LDL cholesterol levels to a standard range.

This article explains LDL cholesterol, recommended levels, and the risks of high levels. It also discusses diagnosis, causes, and how to lower LDL cholesterol.

Sex and gender exist on a spectrum. This article uses the terms “female” and “male” to refer to a person’s sex that was assigned at birth. 

Learn more about the difference between sex and gender.

What is cholesterol?

Many labeled blood samples sit in a test tube rack.
angelp/Getty Images

Cholesterol is a fatty, wax-like substance that your body uses to build cells Trusted Source American Heart Association Highly respected national organization Go to source and other vital substances, such as vitamins and hormones. Cholesterol is not necessarily always bad, but this can depend on the type of cholesterol.

LDL cholesterol vs. HDL cholesterol

LDL cholesterol is known as “bad” cholesterol. Having too much can cause Trusted Source American Heart Association Highly respected national organization Go to source it to build up in the arteries.

High-density lipoprotein, or HDL cholesterol, is known as “good” cholesterol. Limited amounts of HDL can absorb Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source LDL and take it to the liver to be removed from the body.

Some amounts of LDL of HDL in the blood can be healthy. However, high levels of LDL and too low levels of HDL may increase the risk of cardiovascular diseases.

Cholesterol levels can be measured in milligrams per deciliter (mg/dL).

According to the National Library of Medicine, recommended LDL cholesterol levels are less than 100 mg/dL for all people. Having LDL levels over 100 mg/dL may be considered having high cholesterol.

However, when measuring cholesterol levels, clinicians may take several values depending on the type of cholesterol and fat. This is done with a blood test known as a lipoprotein panel.

The following are recommended levels for other types of cholesterol:

Type of cholesterolAge 19 or youngerFemales age 20 or overMales age 20 or over
Total cholesterolless than 170 mg/dL125 to 200 mg/dL125 to 200 mg/dL
HDLmore than 45 mg/dL50 mg/dL or more40 mg/dL or more
Non-HDLless than 120 mg/dLless than 130 mg/dLless than 130 mg/dL

Non-HDL levels refer to the total amount of cholesterol in the blood minus HDL. This includes LDL and other types of fats such as very-low-density lipoprotein and triglycerides.

It is important to note that these values are just guides. What cholesterol levels may be healthful for each person can vary, depending on personal factors such as underlying health.

Contact a doctor for advice about cholesterol levels and target ranges.

What causes high LDL levels?

According to the American Heart Association, the body naturally makes all the LDL cholesterol needed for essential processes such as cell repair.

However, other factors can cause LDL levels to rise, such as:

  • Genetics: Some people inherit genes from their biological parents that cause Trusted Source American Heart Association Highly respected national organization Go to source them to have higher levels of cholesterol. This is known as familial hypercholesterolemia.
  • Smoking and exposure to smoke: Smoking may rise LDL levels and reduce HDL cholesterol.
  • Being overweight or obese: Being obese or overweight may raise Trusted Source American Heart Association Highly respected national organization Go to source LDL cholesterol and lower HDL cholesterol levels.
  • Low rates of physical activity: Not exercising enough may increase LDL cholesterol.
  • Drinking too much alcohol: Large amounts of alcohol may increase total cholesterol levels.
  • Stress: Stress can raise the levels of some hormones that may cause the body to produce more cholesterol.
  • Unbalanced diets: Unbalanced diets that include higher levels of saturated or trans fats may increase LDL.

Saturated and trans fats may be more common in foods such as:

  • some highly processed and preprepared foods
  • fatty cuts of meat, such as sausages or lamp chops
  • dairy, such as cream and hard cheeses
  • baked goods, such as cakes and cookies
  • coconut and palm oil
  • cooking fats, such as:
    • butter
    • ghee
    • lard
    • margarine

Underlying health conditions can increase the risk of developing high cholesterol levels. These conditions can include:

  • sleep apnea
  • polycystic ovary syndrome (PCOS)
  • diabetes
  • chronic kidney disease
  • HIV
  • hypothyroidism
  • lupus

What are the health effects of high LDL levels?

If you have too much LDL cholesterol, this cholesterol can buildup in the arteries and lead to blockages or narrowing. This is known as atherosclerosis. Atherosclerosis can increase blood pressure and may raise the risk of related cardiovascular conditions, such as:

  • stroke and transient ischemic attack
  • aneurysms
  • heart attack
  • peripheral artery disease
  • coronary artery disease
  • renal artery stenosis

Read more about types of heart disease.

How do I find out if I have high LDL levels?

High LDL levels do not usually Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source cause symptoms. Instead, doctors may identify high LDL levels on a routine blood test during a checkup or with a blood test for another condition.

The National Institutes of Health (NIH) recommend that most healthy people get their cholesterol levels checked with the following frequency, depending on age:

  • once every 5 years, starting from the ages of 9–11 or from 2 years old if the child has a family history of high cholesterol or cardiovascular disease
  • once every 1–2 years for males ages 45–65 and females ages 55–65
  • once every year for people over the age of 65

However, you may need to have checkups more often if you are at high risk, such as:

  • You have another cardiovascular condition, for example, high blood pressure.
  • You have diabetes.
  • You have a family history of high cholesterol or other cardiovascular conditions.
  • You are obese or overweight.

How do I lower high LDL levels?

According to the NIH, the following approaches may help lower LDL cholesterol levels:

  • getting regular exercise
  • maintaining a moderate weight
  • managing stress, such as with counseling or meditation
  • quitting smoking if you smoke
  • getting enough high-quality sleep
  • limiting alcohol
  • eating a diet that includes:
    • lean proteins, fresh fruits and vegetables, and whole grains
    • low saturated and trans fats
    • low in added sugars
    • limited processed and preprepared foods

Learn more about diets for cholesterol cardiovascular health.

Medication

If necessary, your doctor may also prescribe medications to help decrease LDL levels. Medications can include:

  • Statins: Statins lower the LDL cholesterol the body produces from the liver.
  • Bile acid sequestrants: These help remove cholesterol from the blood.
  • Niacin or nicotinic acid: Niacin may lower LDL cholesterol and increase HDL cholesterol.
  • Fibrates: These may increase the removal of LDL particles.
  • Injectable medications: Medications such as PCSK9 inhibitors may decrease the amount of LDL in the blood. They may be used for people with familial hypercholesterolemia.

Summary

In high amounts, LDL, known as “bad” cholesterol, can buildup in the arteries with other fats and substances and result in atherosclerosis. The condition can increase blood pressure and the risk of other cardiovascular conditions.

High LDL cholesterol levels do not usually cause symptoms but may be detected during a blood test.

Among other factors, high LDL levels can be caused by genetics, diets high in saturated fats, and smoking. Medication and changing lifestyle factors smoking can lower LDL levels.

Contact a doctor for advice about LDL cholesterol, checkups, and treatment.

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  2. Cholesterol. (n.d.). https://www.heart.org/en/health-topics/cholesterol
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  6. Herath, P., et al. (2021). Effect of cigarette smoking on smoking biomarkers, blood pressure and blood lipid levels among Sri Lankan male smokers. https://pmj.bmj.com/content/98/1165/848
  7. LDL: The "bad" cholesterol. (2023). https://medlineplus.gov/ldlthebadcholesterol.html
  8. Pahwa, R., et al. (2022). Atherosclerosis. https://www.ncbi.nlm.nih.gov/books/NBK507799/
  9. Pirahanchi, Y., et al. (2022). Biochemistry, LDL cholesterol. https://www.ncbi.nlm.nih.gov/books/NBK519561/
  10. What is blood cholesterol? (2022). https://www.nhlbi.nih.gov/health/blood-cholesterol
  11. What is high cholesterol? (2022). https://www.nhs.uk/conditions/high-cholesterol/

Medical Reviewer: Megan Soliman, MD
Last Review Date: 2023 Apr 13
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