High Cholesterol: What to know and what to do

High cholesterol usually causes no symptoms, but it quietly raises your risk of heart disease and stroke. If you’ve seen numbers you don’t like, or a family history of heart problems, this page gives straight, useful steps you can take now — from testing to diet, lifestyle and medicines to discuss with your doctor.

What causes high cholesterol and how we test

Cholesterol is a mix of good (HDL) and bad (LDL) particles. High LDL and low HDL are the usual problem. Age, family history, being overweight, poor diet, lack of exercise, smoking and some medications can push numbers up. Certain conditions like diabetes and hypothyroidism matter too.

A lipid panel measures total cholesterol, LDL, HDL and triglycerides. Doctors often look at your overall heart risk, not just one number. That means they combine your cholesterol with age, blood pressure, smoking status and diabetes to decide treatment. If you haven’t tested recently, ask for a fasting or non-fasting lipid panel — both are useful.

Practical steps to lower cholesterol

Start with what you can control. Swap out foods high in saturated and trans fats. Cut back on processed snacks, fried foods and fatty cuts of meat. Replace them with vegetables, whole grains, beans and lean proteins. Oily fish (salmon, sardines) twice a week gives omega-3s that help triglycerides.

Small, specific changes work better than big promises. Try these: use olive oil instead of butter, snack on nuts or fruit instead of chips, and add one extra serving of vegetables to dinner. Losing even 5% of body weight often improves cholesterol.

Move more. Aim for at least 150 minutes of moderate activity per week — brisk walking counts. Strength training twice weekly helps too. Quitting smoking raises HDL fast, and limiting alcohol keeps triglycerides in check.

Some over-the-counter options can help a little: soluble fiber (psyllium), plant sterols, and fish oil supplements. They aren’t a substitute for other measures, but they can add benefit when used properly. Talk to your provider before starting supplements.

If lifestyle changes don’t get you to goal, medications are common and effective. Statins are the first choice for most people — they cut LDL and lower heart risks. Ezetimibe can be added if needed. For people with very high risk or genetic high cholesterol, newer options like PCSK9 inhibitors or bempedoic acid may be offered. Costs, convenience and insurance vary, so discuss pros and cons with your clinician.

Keep it simple: get tested, try concrete diet and activity swaps, use supplements only as advised, and review medicines with your doctor based on your personal heart risk. Regular follow-up checks show what’s working and what needs adjusting.

If you’re unsure where to start, ask your doctor for a clear target LDL number and a plan you can stick with. Small, steady changes add up — and most people can significantly lower their risk with the right mix of habits and treatment.