Your cholesterol: Watching and managing it

It's easy for cholesterol levels to get out of control and threaten your health. That's why health experts encourage people to watch and manage their cholesterol.

What is cholesterol?

Cholesterol is a hard waxy substance that the liver makes naturally. It's also in animal foods, such as meat, whole milk and egg yolks.

Your body needs cholesterol to…

digest fats
make certain hormones (such as estrogen and testosterone) and vitamin D
maintain cell walls or membranes

Why watch my cholesterol?

The typical American diet includes a lot of fat and sugar. Diet and other factors can cause our body’s natural production of cholesterol to slow down. Then extra cholesterol builds up in the arteries.

Coronary arteries are main blood vessels that bring oxygen to the heart. When cholesterol deposits restrict blood flow to the heart, you may feel a chest pain known as angina. When a coronary artery becomes completely blocked, you will have a heart attack.

Checking your cholesterol

Every three to five years, people age 20 and older should go to their doctor for a blood test that measures their cholesterol three ways:

Total blood cholesterol should be below 200 mg/dL (milligrams per deciliter of blood). A reading of 240 or more doubles your risk for heart disease.
High-density lipoprotein (HDL), "good" cholesterol, keeps cholesterol from building up in the arteries. An HDL level of 40 mg/dL or higher can protect you from heart disease.
Low-density lipoprotein (LDL), "bad" cholesterol, can cause artery blockage. An LDL level less than 100 mg/dL is considered safe for most people. But if you have heart disease, diabetes, stroke or vascular disease, it is recommended that your LDL be less than 70 mg/dL.

Managing your risks

Heredity, age and gender can make you prone to high cholesterol.

Heredity: Genes play a role in how fast "bad" cholesterol (LDL) is made and removed from the bloodstream.
Age and gender: Before menopause, women generally have lower "bad" cholesterol than men their age. In both genders, cholesterol tends to rise with age. After menopause, many women experience a rise in "bad" cholesterol and a decrease in "good" cholesterol (HDL).

While you can't do anything about your heredity, gender or age, you can control other risk factors for high cholesterol. This is why, to prevent or treat heart disease, health experts often recommend that you…

eat a low-fat, low-cholesterol diet
get regular exercise (This can help you lose weight, if needed, and manage stress.)
stop smoking
drink alcohol only in moderation

When making lifestyle changes, it's best to talk with your doctor and come up with a plan to integrate changes gradually in a way that works for you.

Taking medicine

In addition to a healthy diet and regular exercise, some people need to take medicine to lower high cholesterol. Their doctor may recommend aspirin therapy or statins.

Aspirin therapy is often prescribed for people who don't already have heart disease. Low doses of aspirin – usually one tablet a day – can reduce the clotting mechanism of blood, assisting blood flow.
Statins generally are prescribed for people who have had a heart attack, have angina, or are at risk of getting heart disease or heart attack.

Surgery sometimes necessary

Surgery may be necessary if your arteries are blocked by too much cholesterol.

Angioplasty with stents is one of the most common treatments.
Coronary artery bypass surgery is a more complex procedure to improve blood flow to the heart.