Table of ContentsView AllTable of ContentsLDL EffectsTestingInterpretationLDL and Total CholesterolRisksHow to Lower LDLFAQs
Table of ContentsView All
View All
Table of Contents
LDL Effects
Testing
Interpretation
LDL and Total Cholesterol
Risks
How to Lower LDL
FAQs
A waxy compound found in your body’s cells, cholesterol is manufactured in the liver and present in some foods. There are two types of proteins that carry cholesterol through the bloodstream: high density lipoprotein (HDL) and low density lipoprotein (LDL). HDL is considered“good” cholesterol, as it absorbs cholesterol and brings it back to the liver, whereas LDL is “bad" cholesterol.
What makes LDL so concerning? Why is it bad? High levels can causeplaqueto form in your arteries. In turn, this can lead to a range of serious conditions, such ascoronary artery disease (CAD)andperipheral artery disease (PAD), among others.These diseases are leading causes ofheart attackandstroke.
This being the case, checking LDL levels—as part of a broader assessment of cholesterol—is an essential part of a routine physical. If your levels are high, you’ll need to manage the condition, which can mean everything from adoptinglifestyle changesto taking medication. Learning more about cholesterol and LDL helps you understand your health overall.
Verywell / Jessica Olah
Why LDL Cholesterol Is Bad
The chief issue when there are excessive levels of LDL is the formation of plaque within the walls of arteries, leading to atherosclerosis. These atherosclerotic plaques can stiffen, narrow, and harden the walls of the arteries, which deliver oxygen-rich blood from the heart to the rest of the body.
Also, the plaques can rupture, which causes different types of blood cells to come rushing to the exposed ruptured plaque, stick to it, and acutely clog the artery. The acute clogging can cause a heart attack or stroke, depending upon which artery is clogged.
Constriction or blockages of blood flow lead to a veritable cascade of serious health conditions. When they occur in coronary arteries (those of the heart), you can develop CAD, which can lead to heart attack.
High LDL is also associated with diseases of other arteries, as in PAD and carotid artery disease.Blockages in carotid arteries from CAD can lead to a stroke, while blockages in peripheral arteries are more likely to cause pain in the arms or legs.
Lower “Bad” LDL Cholesterol While Raising “Good” HDL Cholesterol
Measuring LDL Cholesterol Levels
Given the severity of what it can lead to, it’s little wonder that screening LDL levels is an important and essential part of health evaluation. This is measured using a blood test called a lipoprotein profile. Here’s a breakdown of how the assessment works:
Recommendations as to how often you should have your cholesterol levels checked vary based on your age and health status. Typically, adults over the age of 20 should be screened once every five years, with the first test administered when children are 9 to 11. Men aged 45 to 65, and women 55 to 65 should be screened every one to two years.
However, more frequent assessment is needed for those who have certain risk-factors for heart disease, including:
Notably, in men over 40, LDL levels will be part of an equation used to determine risk of developing stroke or heart attack within 10 years.
What LDL Levels Mean
When you have your cholesterol checked, you usually receive a consultation to help explain what the measures mean. As mentioned, high LDL levels are a red flag, as are those of triglycerides; when the latter are also higher than normal, it can be a sign that atherosclerosis has already developed.
LDL levels are broken down into five specific categories, defined as optimal and near optimal, often considered healthy ranges, as well as borderline high, high, and very high. The results are expressed as milligrams (mg) per deciliter (dL).
LDL Levels and Health IssuesThose with existent CAD, PAD, or other cardiovascular issues will want to keep their LDL lower than 70 mg/dL. Diabetes patients will want theirs to be less than 100 mg/dL.
LDL Levels and Health Issues
Those with existent CAD, PAD, or other cardiovascular issues will want to keep their LDL lower than 70 mg/dL. Diabetes patients will want theirs to be less than 100 mg/dL.
How LDL Impacts Total Cholesterol
Physiologically speaking, LDL represents a majority of your blood cholesterol; however, as noted, HDL and triglycerides are also present in significant amounts. Total cholesterol levels—while not as clinically significant for isolated heart and circulation issues—give a decent glimpse of cardiovascular health.
Dangers of High LDL Cholesterol
Elevated LDL levels are associated with a range of medical conditions, some of which are very dangerous. Most notable of these are:
How To Lower High LDL Cholesterol
If your LDL levels are found to be borderline high, high, or very high, you’ll need to manage the condition and lower them. While some approaches can be challenging to keep up with, they’re usually quite successful. Oftentimes, successfully lowering bad cholesterol will require mixing and matching methods. What’s most important is that you detect any abnormalities as soon as you can and remain proactive in taking them on.
Diet
One of the most influential factors in determining cholesterol and LDL levels is diet. On top of a well-balanced diet, you’ll need to steer clear of food-borne sources of cholesterol, trans fats, and saturated fat. This may mean avoiding:
In place of these, a heart-healthy diet should help. This emphasizes:
Oftentimes, the treatment of high LDL entails counseling about diet, among other lifestyle factors that can help.
Exercise
Regular exercise, along with a good diet, can also help bring LDL levels to an optimal range. Currently, it’s recommended that you aim for a bare minimum of 150 minutes (2.5 hours) of physical activity a week. This can be more extensive fitness work, or it can be as simple as taking a daily—or nearly daily—30 minute walk.
Weight Loss
One of the strongest risk factors for developing high LDL, as well as associated heart diseases or other issues, is being overweight or obese.Losing even 10 pounds can go a long way towards significantly improving your health status. However, it’s also important to be careful and safe; talk to your doctor or a nutritionist about healthy and sustainable ways to shed pounds.
Medications
Several classes of drugs can help take on high LDL levels. These include:
Other Lifestyle Changes
In addition to diet, exercise, and medications, there are several other lifestyle changes that can help lower LDL cholesterol levels. These include:
Lipoprotein apheresis
For those with highly elevated LDL levels that are resistant to management or treatment, as in an inherited condition called familialhypercholesterolemia, a nonsurgical treatment called lipoprotein apheresis may also be used. This involves running blood plasma through a special machine that removes LDL.
Summary
Screening blood tests to measure LDL cholesterol levels are important in assessing your long-term risk for cardiovascular disease. If your risk is found to be elevated due to your LDL levels, you will need to work with your health care provider to take the necessary steps to bring that risk down.
What is a normal LDL level?
While healthy ranges of overall cholesterol vary based on how old you are and your sex, the normal, healthy range for LDL is consistent. For men and women over the age of 19, doctors want to see this level below 100 mg/dL.
What causes high LDL cholesterol?
High LDL is when there are unhealthy elevated levels of this cholesterol in your blood.A range of factors cause these to rise, including:
What should I do if my LDL cholesterol is high?
If your LDL is found to be high, you and your doctor will need to come up with a plan to manage this condition. You’ll get instructions about dietary changes you need to make and will be encouraged to adopt a healthier, more active lifestyle; this is typically the first step in taking on high cholesterol.
Make sure your levels are being regularly monitored, and keep track of your progress. If changing lifestyle habits alone isn’t enough, you and your doctor can consider pharmaceutical approaches.
How can I lower my LDL cholesterol without medications?
The first step in managing any case of high LDL is through adopting healthy, therapeutic lifestyle changes (TLC). The key to TLC is:
What medications are used to reduce LDL cholesterol?
There are several classes of drugs prescribed for high LDL. These include:
What is a good LDL to HDL ratio?
Generally speaking, the higher this number, the higher the risk of heart problems. Doctors want to see a ratio below 5:1, with those below 3.5:1 considered ideal.Since lowering LDL causes total cholesterol numbers to drop, it promotes a better cholesterol ratio.
Can LDL cholesterol levels be too low?
There is no medically-established LDL level that’s too low; however, scores of 40 mg/dL or below have been associated with depression, anxiety, and stroke. Very low levels are also a hallmark offamilial hypobetalipoproteinemia, a genetic disorder that causes problems with fat absorption and liver health, while leading to vitamin deficiencies.
13 SourcesVerywell 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.Centers for Disease Control and Prevention.LDL and HDL cholesterol and triglycerides.National Institutes of Health.LDL: the “bad” cholesterol.American Heart Association.How to get your cholesterol tested.National Institutes of Health.Cholesterol levels: what you need to know.Centers for Disease Control and Prevention.Testing for cholesterol.Cleveland Clinic.Cholesterol numbers: What do they mean.American Heart Association.What your cholesterol levels mean.National Heart, Lung, and Blood Institute.What is blood cholesterol?UC San Diego Health.Apheresis program.American Heart Association.Cholesterol medications.Calling, S., Johansson, SE., Wolff, M.et al.The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in Women’s health in the Lund area (WHILA): a 17-year follow-up cohort study.BMC Cardiovasc Disord19, 239 (2019). https://doi.org/10.1186/s12872-019-1228-7University of Rochester Medical Center.Lipid panel with total cholesterol: HDL ratio.National Institutes of Health.Familial hypobetalipoproteinemia.
13 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.Centers for Disease Control and Prevention.LDL and HDL cholesterol and triglycerides.National Institutes of Health.LDL: the “bad” cholesterol.American Heart Association.How to get your cholesterol tested.National Institutes of Health.Cholesterol levels: what you need to know.Centers for Disease Control and Prevention.Testing for cholesterol.Cleveland Clinic.Cholesterol numbers: What do they mean.American Heart Association.What your cholesterol levels mean.National Heart, Lung, and Blood Institute.What is blood cholesterol?UC San Diego Health.Apheresis program.American Heart Association.Cholesterol medications.Calling, S., Johansson, SE., Wolff, M.et al.The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in Women’s health in the Lund area (WHILA): a 17-year follow-up cohort study.BMC Cardiovasc Disord19, 239 (2019). https://doi.org/10.1186/s12872-019-1228-7University of Rochester Medical Center.Lipid panel with total cholesterol: HDL ratio.National Institutes of Health.Familial hypobetalipoproteinemia.
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.
Centers for Disease Control and Prevention.LDL and HDL cholesterol and triglycerides.National Institutes of Health.LDL: the “bad” cholesterol.American Heart Association.How to get your cholesterol tested.National Institutes of Health.Cholesterol levels: what you need to know.Centers for Disease Control and Prevention.Testing for cholesterol.Cleveland Clinic.Cholesterol numbers: What do they mean.American Heart Association.What your cholesterol levels mean.National Heart, Lung, and Blood Institute.What is blood cholesterol?UC San Diego Health.Apheresis program.American Heart Association.Cholesterol medications.Calling, S., Johansson, SE., Wolff, M.et al.The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in Women’s health in the Lund area (WHILA): a 17-year follow-up cohort study.BMC Cardiovasc Disord19, 239 (2019). https://doi.org/10.1186/s12872-019-1228-7University of Rochester Medical Center.Lipid panel with total cholesterol: HDL ratio.National Institutes of Health.Familial hypobetalipoproteinemia.
Centers for Disease Control and Prevention.LDL and HDL cholesterol and triglycerides.
National Institutes of Health.LDL: the “bad” cholesterol.
American Heart Association.How to get your cholesterol tested.
National Institutes of Health.Cholesterol levels: what you need to know.
Centers for Disease Control and Prevention.Testing for cholesterol.
Cleveland Clinic.Cholesterol numbers: What do they mean.
American Heart Association.What your cholesterol levels mean.
National Heart, Lung, and Blood Institute.What is blood cholesterol?
UC San Diego Health.Apheresis program.
American Heart Association.Cholesterol medications.
Calling, S., Johansson, SE., Wolff, M.et al.The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in Women’s health in the Lund area (WHILA): a 17-year follow-up cohort study.BMC Cardiovasc Disord19, 239 (2019). https://doi.org/10.1186/s12872-019-1228-7
University of Rochester Medical Center.Lipid panel with total cholesterol: HDL ratio.
National Institutes of Health.Familial hypobetalipoproteinemia.
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