Cholesterol

Cholesterol isn't entirely the health villain it's made out to be, its name darkly linked to heart attack, stroke, and other types of cardiovascular disease. Our bodies need cholesterol, which is a type of lipid (another name for fat) to make cell membranes, key hormones like testosterone and estrogen, the bile acids needed to digest and absorb fats, and vitamin D. Cholesterol is so important to the body that the liver and intestines make it from scratch.

What is "bad" about cholesterol isn't the substance itself — in fact, we can't live without it — but how much of it is in the bloodstream.

The body packages cholesterol in two main particles: low-density lipoprotein (LDL), the so-called bad cholesterol, and high-density lipoprotein (HDL), the so-called good cholesterol. Too much LDL in the bloodstream helps create the harmful cholesterol-filled plaques that grow inside arteries. Such plaques are responsible for angina (chest pain with exertion or stress), heart attacks, and most types of stroke.

What causes a person's LDL level to be high? Most of the time diet is the key culprit. Eating foods rich in saturated fats, trans fats, and easily digested carbohydrates boost LDL. Genes are sometimes at the root of high cholesterol, and some medications can boost LDL.

If you have high cholesterol, making changes in your diet can help bring it down into the healthy range. Exercise can help boost the level of protective HDL. Several types of medication, notably the family of drugs known as statins, can powerfully lower LDL. Depending on your cardiovascular health, your doctor may recommend taking a statin.

Cholesterol Articles

Cholesterol Resource Center

Welcome to our Cholesterol Resource Center.  For more information about cholesterol, see our Special Health Report on Managing Your Cholesterol.  Watch the Rethinking Cholesterol webcast? Tell us how you liked it, take our survey. More »

Beyond statins: New medicines for hard-to-manage cholesterol

Statins succeed as the first-line drug therapy to lower LDL cholesterol levels in most people who need medications, but at least one in five individuals still fails to reach the desired target. A novel class of drugs called PCSK9 inhibitors may pick up the slack where other cholesterol medications leave off. The first group of people to benefit will be those with a condition known as familial hypercholesterolemia (FH), an inherited disorder that affects about one in 200 individuals. These people carry a genetic variant that causes cholesterol levels to skyrocket. (Locked) More »

Ask the doctor: Statins and liver tests

Continuing liver function tests are not required for most people taking cholesterol-lowering statin drugs. One test before starting the drug is all that is required unless the person is at elevated risk of liver problems. More »

Know your triglycerides: Here's why

Triglycerides are fatty substances (lipids) in the blood that, like “bad” LDL cholesterol, may contribute to risk of heart attacks and strokes. Unless triglycerides are very high, they do not require medication to lower them. Men with mildly to moderately high triglycerides are advised to exercise, lose weight if they are overweight, improve their diet, and reduce alcohol consumption to lower their risk and bring triglycerides to the normal range. Men at above-average cardiovascular risk with high triglycerides can benefit from taking a cholesterol-lowering statin drug. (Locked) More »

For "bad" cholesterol, lower is better; dual drug therapy may help

High cholesterol, in particular high low-density lipoprotein (LDL), the so-called bad cholesterol, is a key cause of heart disease. A large clinical trial called IMPROVE-IT set out in 2005 to answer two key questions about LDL: The results of IMPROVE-IT were recently published in The New England Journal of Medicine. Dr. Deepak L. Bhatt, Editor in Chief of the Harvard Heart Letter, talked about the significance of the IMPROVE-IT findings with Dr. Christopher P. Cannon, the trial's lead investigator, and Dr. John A. Jarcho, an editor of The New England Journal of Medicine. More »

Ask the doctor: Why does diabetes raise heart disease risk?

People with diabetes face a high risk of heart disease in part because they’re more likely to have other conditions linked to heart disease. But the high blood sugar levels characteristic of diabetes may also harm blood vessels and increase risk of blood clots. (Locked) More »

An avocado a day may keep cholesterol at bay

Eating a cholesterol-lowering diet that includes one avocado per day may lower levels of undesirable LDL cholesterol. The monounsaturated fats, as well as fiber and other compounds found in avocados, likely contribute to this beneficial effect. (Locked) More »

The latest on cholesterol testing

Even though national guidelines on managing cholesterol have shifted away from targeting specific cholesterol levels, tests that measure fats (lipids) in the blood, known as a lipid profile or panel, are still widely used and important. Adults should have a lipid profile done at least every five years. People who have abnormal lipid values or who take cholesterol-lowering medications likely need more frequent tests. The same applies to people with risk factors for heart disease such as diabetes, high blood pressure, or a family history of heart disease. (Locked) More »

Eggs and your health

Eating up to an average of one egg per day can be part of a heart-healthy diet. Moderate egg consumption does not contribute significantly to total cholesterol and risk for heart attack or stroke. More »

How to lower your cholesterol without drugs

Dietary changes can reduce LDL cholesterol. Substitute polyunsaturated and monounsaturated fats for trans fats and saturated fats, avoid refined grains and sugars, and eat three to five servings a day of fruits and vegetables. More »