How Does Cholesterol Cause Heart Disease?

High blood cholesterol is one of the major risk factors for heart disease. In fact, the higher your blood cholesterol, the greater your risk of developing heart disease or having a heart attack. Heart disease is the #1 killer of men and women in the United States. Each year, more than a million Americans have a heart attack, and about half a million people die of heart disease.

When there is too much cholesterol (a fat-like substance)
in your blood, it builds up in the walls of your arteries. Over time, this buildup causes "hardening
of the arteries" so that arteries become narrowed
and blood flow to the heart becomes slowed down or blocked. This may cause chest pain or even a heart attack.
High blood cholesterol itself does not cause symptoms,
so many people are unaware when their
cholesterol is too high. It is important to find out your cholesterol numbers. Lowering levels that are too high lessens the risk of developing heart disease or dying from it if you already have it.

What Do Your Cholesterol Numbers Mean?

Getting a blood test called a fasting lipoprotein profile will give information about your:

Total cholesterol—It is desirable to have a measurement of less than 200 mg/dL.
Low-density lipoprotein (LDL, or "bad") cholesterol—the main source of cholesterol buildup and blockage in the arteries. It is optimal to have an LDL level lower than 100 mg/dL. (The higher your LDL cholesterol level, the greater your chance of getting heart disease.)

High-density lipoprotein (HDL, or "good") cholesterol—which helps keep cholesterol from building up in the arteries. An HDL of ≥ 60 mg/dL will help lower your risk for heart disease. (The higher your HDL cholesterol level, the lower your chance of getting heart disease.)

Triglycerides—another form of fat in your blood. Levels that are borderline high
(150–199 mg/dL) or high (≥ 200 mg/dL) may need treatment in some people.

What Affects Cholesterol Levels?

A variety of things can affect cholesterol levels. These are things you can do something about:
• Diet—Saturated fat and cholesterol in food may increase your cholesterol level.
• Weight—Being overweight tends to increase your cholesterol level.
• Physical activity—Being inactive is a risk factor for heart disease. Regular physical activity can help lower LDL cholesterol and raise HDL cholesterol.

Things you cannot do anything about also can affect your cholesterol levels. These include:
• Age and gender—As people get older, their cholesterol levels rise.
• Heredity—High cholesterol can run in families.

Treating High Cholesterol

The main goal of cholesterol-lowering treatment is to lower your LDL level enough to reduce your risk of developing heart disease or having a heart attack. Four risk categories (numbered I–IV) will affect the type of treatment that is right for you. Talk with your doctor to learn your risk category and recommended
treatment.

There are two main ways to lower your cholesterol:

Therapeutic lifestyle changes (TLC)—includes a cholesterol lowering diet (called the TLC diet), physical activity, and weight management. TLC is for anyone whose LDL is above goal.

Drug therapy—If cholesterol-lowering drugs are needed, they are used together with TLC treatment to help lower LDL. To reduce your risk for heart disease or keep it low, it is very important to control any other risk factors you may have, such as high blood pressure and smoking.