Table of ContentsView AllTable of ContentsWhat Is High Cholesterol?Signs and SymptomsRisk FactorsComplicationsDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is High Cholesterol?
Signs and Symptoms
Risk Factors
Complications
Diagnosis
Treatment
Frequently Asked Questions
Contrary to what some people think, you cannotfeelif your cholesterol levels are high. As with conditions likehigh blood pressureor diabetes, the lack of symptoms doesn’t mean that you are inherently OK or have less to worry about. If left untreated,high cholesterolcan place you at risk of serious complications, including aheart attackorstroke.
High cholesterol is one of the main risk factors for heart disease (alongside high blood pressure andobesity).To better reduce your risk, you need to get your cholesterol tested on a regular basis, particularly as you get older or if you have risk factors for heart disease.
Monkey Business Images / Getty Images
Heart diseaseis today the leading cause of mortality in the United States, accounting for over 655,000 deaths annually, according to the Centers for Disease Control and Prevention.
There are two main types of cholesterol:
In the broadest sense, high cholesterol (also known ashypercholesterolemia) can be described as having too much LDL cholesterol.
There is another form of LDL, calledvery low-density (VLDL) cholesterol, that is responsible for transportingtriglyceridesthrough the body.Triglycerides are another type of lipid that, when elevated, can increase the risk of heart disease.
When Should I Worry About High Cholesterol?
There are generally no overt signs or symptoms of high cholesterol. If you do have symptoms, they are generally related to the consequences of the disease rather than the disease itself. You ultimately cannot “feel” high cholesterol if you have it.
For example, high cholesterol can lead tohypertension(high blood pressure). If your high blood pressure becomes severe enough, you may experience fatigue,difficulty breathing, headaches, vision problems, irregular heartbeats, andchest pains.
Only in severe cases might high cholesterol lead to a skin condition known as xanthoma. These are waxy deposits that develop under the skin, particularly around the eyes, eyelids, hands, elbows, and knees. Xanthomas are mainly associated with a genetic form of the disease known asfamilial hypercholesterolemia.
Ultimately, the only way to know if you have high cholesterol is to get a blood test.
Because you cannot tell if you have high cholesterol, knowing your risk factors can help you determine your need for testing—even if you are otherwise young and healthy. The more risk factors you have, the greater the need and frequency of cholesterol testing.
Some risk factors for high cholesterol are things that we can change, such asdietandexercise. Others cannot be changed, such as your age, sex, or genetics.
If you have any of the conditions listed below, you are at risk of hypercholesterolemia and should be checked:
The risk of high cholesterol also tends to increase with age due to changes in metabolism, warranting more frequent monitoring as you get older.
Top 5 Factors Linked to High Cholesterol
Some people don’t ever think about having their cholesterol checked if they are feeling well. And this can be a mistake since untreated hypercholesterolemia can lead to a number of serious complications.
When cholesterol levels are high, fatty plaques can begin to form on the walls of blood vessels. The condition, referred to asatherosclerosis, causes the progressive obstruction of blood flow to the heart and rest of the body. This not onlyincreases blood pressurebut also raises the risk of a heart attack or stroke if a plaque breaks open, causing a clot that completely blocks blood flow.
In fact, many people do not even realize they have high cholesterol until they have had their first heart attack or stroke. To prevent this, you need to have your cholesterol checked regularly to not only diagnose hypercholesterolemia but determine when treatment is needed.
Do You Need Treatment for High Cholesterol?
The only way to tell if you have high cholesterol is through alipid panel. This is a blood test that measures the level of different blood fats in a sample of blood, most specifically:
A lipid panel is used to establish whether the various levels are high or low based on a reference range of values. Anything between the high and low values is considered normal. Anything outside of the reference value is considered abnormal.
Ultimately, it’s the relationship between the various values—which ones are high and which are low—that determine if your cholesterol levels are acceptable, if treatment is needed, or if you are responding well to treatment.
Your lipid levels are assessed along with other factors, including your age, sex, race, blood pressure, and whether you havediabetesor smoke, to predict your 10-year risk of heart disease.
What Are Healthy Cholesterol and Triglyceride Levels?
If your total cholesterol, LDL, or triglyceride levels are too high or your HDL is too low, your healthcare provider may recommend lifestyle changes, medications, or a combination of interventions to help bring your lipids back to a healthy range.
Lifestyle Modifications
Changes in lifestyle—including ahealthy dietand routine exercise—are the first-line response to high cholesterol. In people with mild hypercholesterolemia, the changes may be all that is needed to bring the cholesterol levels under control.
The American Heart Association recommends the following lifestyle modifications:
Medications
If lifestyle modifications are not enough to bring your high cholesterol under control, your healthcare provider may prescribe cholesterol-lowering drugs. Options include:
Other drugs may be prescribed if you have high triglycerides (hypertriglyceridemia).
Drugs Used to Lower Cholesterol and Triglycerides
A Word From Verywell
Feeling healthy is not necessarily the same thing as being healthy. Neither does having fewer risk factors mean that you won’t develop heart disease in later life. In the end, cholesterol testing is considered a standard part ofprimary careand one of the tools healthcare providers routinely use to better reduce your risk of a heart attack or stroke.
The American Heart Association currently recommends that people over the age of 20 have their cholesterol checked at once at least every four to six years.Those with a family history of high cholesterol or a chronic condition like diabetes may need to get their lipids checked more frequently.
Most people will not experience any symptoms if they have high triglycerides. However, on rare occasions, levels over 1,000 milligrams per deciliter (mg/dL) can trigger acutepancreatitis, causing severe upper abdominal pain, fever, rapid pulse, and nausea or vomiting.
Symptoms of high cholesterol are rare. The only exceptions are skin disorders calledxanthomain which fatty growths develop under the skin (most commonly around the eyes and on the knees, elbows, hands, and feet) orxanthelasmasin which waxy deposits appear on the skin surface. Both are more common in people with genetic forms of high cholesterol.
In addition to cholesterol-lowering drugs likestatins, certain lifestyle changes can help lower your cholesterol whether you are on treatment or not. These include:Eating adietlow in saturated fat and trans fatDoing 150 minutes of moderate-aerobic exercise per weekLosing weight if you are overweight or obeseQuitting cigarettesIn addition to statins, in late 2021 the Food and Drug Administration approved Leqvio (inclisiran)—an injected treatment for use along with diet and maximally tolerated statin therapy for adults who require additional LDL lowering strategies. Millions of people already on cholesterol-lowering medications struggle to reach LDL targets with statins alone.
In addition to cholesterol-lowering drugs likestatins, certain lifestyle changes can help lower your cholesterol whether you are on treatment or not. These include:
In addition to statins, in late 2021 the Food and Drug Administration approved Leqvio (inclisiran)—an injected treatment for use along with diet and maximally tolerated statin therapy for adults who require additional LDL lowering strategies. Millions of people already on cholesterol-lowering medications struggle to reach LDL targets with statins alone.
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Hill MF, Bordoni B.Hyperlipidemia. In:StatPearls. StatPearls Publishing; 2023.
Stewart J, Manmathan G, Wilkinson P.Primary prevention of cardiovascular disease: A review of contemporary guidance and literature.JRSM Cardiovasc Dis. 2017 Jan-Dec;6:2048004016687211. doi:10.1177/2048004016687211
Centers for Disease Control and Prevention.Heart disease facts.
Huff T, Boyd B, Jialal I.Physiology, cholesterol. In:StatPearls.StatPearls Publishing; 2023.
Medline Plus.VLDL cholesterol.
Alves-Bezerra M, Cohen DE.Triglyceride metabolism in the liver.Compr Physiol. 2017;8(1):1-8. doi:10.1002/cphy.c170012
American Heart Association.What are the symptoms of high blood pressure?
Harada-Shiba M, Arai H, Ishigaki Y, et al.Guidelines for diagnosis and treatment of familial hypercholesterolemia 2017.J Atheroscler Thromb.2018;25(8):751-70. doi:10.5551/jat.CR003
American Heart Association.Heart-health screenings.
Centers for Disease Control and Prevention.Knowing your risk for high cholesterol.
Adhyaru BB, Jacobson TA.New cholesterol guidelines for the management of atherosclerotic cardiovascular disease risk: A comparison of the 2013 American College of Cardiology/American Heart Association Cholesterol Guidelines with the 2014 National Lipid Association Recommendations for patient-centered management of dyslipidemia.Endocrinol Metab Clin North Am. 2016 Mar;45(1):17-37. doi:10.1016/j.ecl.2015.09.002
MedlinePlus.Cholesterol levels: What you need to know.
Lloyd-Jones DM, Braun LT, Ndumele CE, et al.Use of risk assessment tools to guide decision-making in the primary prevention of atherosclerotic cardiovascular disease: a special report from the American Heart Association and American College of Cardiology.Circulation.2019;139:e1162–77. doi:10.1161/CIR.0000000000000638
American Heart Association.Prevention and treatment of high cholesterol (hyperlipidemia).
Garg R. Rustagi T.Management of hypertriglyceridemia induced acute pancreatitis.Biomed Res Int. 2018;2018:4721357. doi:10.1155/2018/4721357
MedlinePlus.High cholesterol.
Novartis.FDA approves Novartis Leqvio (inclisiran), first-in-class siRNA to lower cholesterol and keep it low with two doses a year.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.Cookies SettingsAccept All Cookies
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.
Cookies SettingsAccept All Cookies
