High cholesterol does not usually cause symptoms, so it may be tempting to ignore. However, having high blood cholesterol levels is strongly associated with an increased risk of heart attack, stroke, blocked blood vessels in the legs and kidneys, and may even contribute to dementia. Fortunately, diet, exercise, andmedicationshelp lower cholesterol levels and reduce your risk of these serious health problems.
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High Cholesterol and Heart Disease
People who have high cholesterol have a much higher risk of developing heart disease than people with normal cholesterol levels.
For example, a cholesterol level of 250 increases the chances of developingcoronary heart disease, and a level of 300 increases the risk even further. People with high cholesterol—with or without coronary heart disease—are more likely to die from heart disease than those who have a cholesterol level below 200.
Cholesterol is a sticky, waxy substance that circulates in the blood. Your body has a few different types of cholesterol.
The most common arelow-density lipoprotein(LDL) andhigh-density lipoprotein(HDL):
LDL is what is usually referred to when the aim is to lower cholesterol. Ruptured plaques may block blood flow in the coronary arteries causing a heart attack.
Cholesterol of 250: Is That High?
Cholesterol Particle Size
Researchers have discovered that cholesterol chemistry is more complex than what was known just a few years ago. For instance, LDL cholesterol can reside in particles of different sizes: small, dense LDL particles, and large, fluffy LDL particles.
The small LDL particles appear to increase a person’s cardiac risk more than the large particles. Similarly, small and large particles of HDL cholesterol have also been identified, and the two sizes also affect cardiovascular risk differently.
At this time, experts do not recommend measuring LDL and HDL particle size on a routine basis because collecting this information usually does not affect treatment options.Such measurements may become more routine as scientists learn more about cholesterol particle size, and in particular, learn ways to change cholesterol particle size to improve health outcomes.
What Is Small, Dense LDL?
Plaques
Atherosclerotic plaques can suddenly rupture, leading to blood clots and acute blockage of an artery. This sudden blockage can cause a heart attack or a stroke.
High Cholesterol and Strokes
Plaques may stick in the carotid arteries in the neck, or in the arteries in the brain.
When a piece of plaque dislodges from a carotid artery, it can travel to the brain causing a “brain attack” or stroke.
High Cholesterol and Dementia
Taking Care of Your Cholesterol
With heart-healthy diet changes, it may be possible to reduce cholesterol levels to a normal range or closer to a normal range.
It can be challenging to change years of eating habits. Rather than a complete diet overhaul, you can modify your diet gradually, easing your way into a healthier lifestyle.
For example:
The best way to improve HDL is through exercise, such as walking, jogging, cycling, swimming, aerobics, or hiking. If fitness is new to your lifestyle, you may need to try several different exercises before finding a plan that works for you. Some people like to exercise at home, whereas others prefer a gym. Some people exercise in the morning and some prefer to exercise later in the evening.
If your doctor prescribes cholesterol-lowering drugs for you, be sure to tell them about any other medications, supplements, or herbs that you are taking and to take your medications as directed.
Sometimes these drugs may cause uncomfortableside effects, such as nausea, abdominal pain, or muscle cramps. Mention any side effects you are experiencing to your doctor right away. In most cases, there are treatments to relieve the symptoms, or your doctor may switch you to a different medication.
Statins
Many people use cholesterol-lowering medications such as statins, which can reduce the possibility of heart disease.Lipitor (atorvastatin), Zocor (simvastatin), and Crestor (rosuvastatin) are examples of commonly prescribed statins.
Statins are one of the only categories of cholesterol-lowering drugs that have been shown in many clinical trials to improve outcomes in people at high risk for cardiovascular events. More recently the medications PCSK9i and bempedoic acid have also been shown to have improved cardiac outcomes.
Statins have several properties that might reduce or stabilize plaques—it is not clear whether the cholesterol-lowering action of statins provides their chief benefit.This is why current guidelines recommend instituting statin therapy based on a person’s overall cardiovascular risk, and not on their cholesterol levels.
Since cholesterol guidelines rely so heavily on statins, these drugs are recommended for many more people than they were just a few years ago—this fact has created much controversy.
Statins can also prevent strokes.And some studies suggest that taking statins may help prevent vascular dementia and possibly slow the progression of dementia that’s related to Alzheimer’s disease.
What’s Affecting Your Cholesterol?
6 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.Blesso CN, Fernandez ML.Dietary cholesterol, serum lipids, and heart disease: Are eggs working for or against you?Nutrients. 2018;10(4):426 doi:10.3390/nu10040426Ivanova EA, Myasoedova VA, Melnichenko AA, Grechko AV, Orekhov AN.Small dense low-density lipoprotein as biomarker for atherosclerotic diseases.Oxid Med Cell Longev. 2017;2017:1273042. doi:10.1155/2017/1273042Habchi J, Chia S, Galvagnion C, et al.Cholesterol catalyses Aβ42 aggregation through a heterogeneous nucleation pathway in the presence of lipid membranes.Nat Chem. 2018;10(6):673-683. doi:10.1038/s41557-018-0031-xLardizabal JA, Deedwania PC.Benefits of statin therapy and compliance in high risk cardiovascular patients.Vasc Health Risk Manag. 2010;6:843-853.Grundy SM, Stone NJ, Bailey AL, et al.2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.J Am Coll Cardiol. 2019;73(24):3168-3209. doi:10.1016/j.jacc.2018.11.002Schultz BG, Patten DK, Berlau DJ.The role of statins in both cognitive impairment and protection against dementia: a tale of two mechanisms.Transl Neurodegener. 2018;7:5. doi:10.1186/s40035-018-0110-3Additional ReadingSoliman GA.Dietary cholesterol and the lack of evidence in cardiovascular disease.Nutrients. 2018;10(6).10.3390/nu10060780Zhang X, Wen J, Zhang Z.Statins use and risk of dementia: A dose-response meta analysis.Medicine(Baltimore). 2018;97(30):e11304.10.1097/MD.0000000000011304
6 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.Blesso CN, Fernandez ML.Dietary cholesterol, serum lipids, and heart disease: Are eggs working for or against you?Nutrients. 2018;10(4):426 doi:10.3390/nu10040426Ivanova EA, Myasoedova VA, Melnichenko AA, Grechko AV, Orekhov AN.Small dense low-density lipoprotein as biomarker for atherosclerotic diseases.Oxid Med Cell Longev. 2017;2017:1273042. doi:10.1155/2017/1273042Habchi J, Chia S, Galvagnion C, et al.Cholesterol catalyses Aβ42 aggregation through a heterogeneous nucleation pathway in the presence of lipid membranes.Nat Chem. 2018;10(6):673-683. doi:10.1038/s41557-018-0031-xLardizabal JA, Deedwania PC.Benefits of statin therapy and compliance in high risk cardiovascular patients.Vasc Health Risk Manag. 2010;6:843-853.Grundy SM, Stone NJ, Bailey AL, et al.2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.J Am Coll Cardiol. 2019;73(24):3168-3209. doi:10.1016/j.jacc.2018.11.002Schultz BG, Patten DK, Berlau DJ.The role of statins in both cognitive impairment and protection against dementia: a tale of two mechanisms.Transl Neurodegener. 2018;7:5. doi:10.1186/s40035-018-0110-3Additional ReadingSoliman GA.Dietary cholesterol and the lack of evidence in cardiovascular disease.Nutrients. 2018;10(6).10.3390/nu10060780Zhang X, Wen J, Zhang Z.Statins use and risk of dementia: A dose-response meta analysis.Medicine(Baltimore). 2018;97(30):e11304.10.1097/MD.0000000000011304
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.
Blesso CN, Fernandez ML.Dietary cholesterol, serum lipids, and heart disease: Are eggs working for or against you?Nutrients. 2018;10(4):426 doi:10.3390/nu10040426Ivanova EA, Myasoedova VA, Melnichenko AA, Grechko AV, Orekhov AN.Small dense low-density lipoprotein as biomarker for atherosclerotic diseases.Oxid Med Cell Longev. 2017;2017:1273042. doi:10.1155/2017/1273042Habchi J, Chia S, Galvagnion C, et al.Cholesterol catalyses Aβ42 aggregation through a heterogeneous nucleation pathway in the presence of lipid membranes.Nat Chem. 2018;10(6):673-683. doi:10.1038/s41557-018-0031-xLardizabal JA, Deedwania PC.Benefits of statin therapy and compliance in high risk cardiovascular patients.Vasc Health Risk Manag. 2010;6:843-853.Grundy SM, Stone NJ, Bailey AL, et al.2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.J Am Coll Cardiol. 2019;73(24):3168-3209. doi:10.1016/j.jacc.2018.11.002Schultz BG, Patten DK, Berlau DJ.The role of statins in both cognitive impairment and protection against dementia: a tale of two mechanisms.Transl Neurodegener. 2018;7:5. doi:10.1186/s40035-018-0110-3
Blesso CN, Fernandez ML.Dietary cholesterol, serum lipids, and heart disease: Are eggs working for or against you?Nutrients. 2018;10(4):426 doi:10.3390/nu10040426
Ivanova EA, Myasoedova VA, Melnichenko AA, Grechko AV, Orekhov AN.Small dense low-density lipoprotein as biomarker for atherosclerotic diseases.Oxid Med Cell Longev. 2017;2017:1273042. doi:10.1155/2017/1273042
Habchi J, Chia S, Galvagnion C, et al.Cholesterol catalyses Aβ42 aggregation through a heterogeneous nucleation pathway in the presence of lipid membranes.Nat Chem. 2018;10(6):673-683. doi:10.1038/s41557-018-0031-x
Lardizabal JA, Deedwania PC.Benefits of statin therapy and compliance in high risk cardiovascular patients.Vasc Health Risk Manag. 2010;6:843-853.
Grundy SM, Stone NJ, Bailey AL, et al.2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.J Am Coll Cardiol. 2019;73(24):3168-3209. doi:10.1016/j.jacc.2018.11.002
Schultz BG, Patten DK, Berlau DJ.The role of statins in both cognitive impairment and protection against dementia: a tale of two mechanisms.Transl Neurodegener. 2018;7:5. doi:10.1186/s40035-018-0110-3
Soliman GA.Dietary cholesterol and the lack of evidence in cardiovascular disease.Nutrients. 2018;10(6).10.3390/nu10060780Zhang X, Wen J, Zhang Z.Statins use and risk of dementia: A dose-response meta analysis.Medicine(Baltimore). 2018;97(30):e11304.10.1097/MD.0000000000011304
Soliman GA.Dietary cholesterol and the lack of evidence in cardiovascular disease.Nutrients. 2018;10(6).10.3390/nu10060780
Zhang X, Wen J, Zhang Z.Statins use and risk of dementia: A dose-response meta analysis.Medicine(Baltimore). 2018;97(30):e11304.10.1097/MD.0000000000011304
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