What is Cholesterol?
Cholesterol is a fatty substance in the blood. You need some cholesterol to be healthy, but too much can build up in your arteries and may cause a heart attack or stroke.
Total cholesterol is the amount of cholesterol in your blood. It is made up of:
- LDL, the bad cholesterol
- HDL, the good cholesterol
- Triglycerides, a type of fat in the blood
Cholesterol is measured with a blood test that is ordered by your nurse or doctor. This test is sometimes called a cholesterol panel or a lipid panel. The lipid panel may include a non-HDL cholesterol value. The non-HDL cholesterol calculation is the total cholesterol minus the HDL cholesterol.
Your nurse or doctor will determine how often you need to have a cholesterol blood test.
Count Your Risk Factors
Cholesterol is just one risk factor for heart attack or stroke.
If you have not had a heart or stroke, your healthcare team may use a tool such as the ASCVD Risk Estimator Plus to help determine your risk of a heart attack or stroke.
Enter the following information into the risk estimator:
- Blood pressure
- Systolic: top number
- Diastolic: bottom number
- Total Cholesterol
- Diabetes: yes or no
- Smoking: current, former, or never
- Medicines you take:
- Blood pressure
Other Risk Factors to Consider
- Family history of early heart disease or strokes
- Metabolic Syndrome
- High triglycerides
- Low HDL
- High blood pressure, or taking medicine for high blood pressure
- High blood sugar, or taking diabetes medicines
- Kidney disease
- conditions such as lupus, rheumatoid arthritis, HIV, psoriasis
- Some high-risk ethnicities, such as South Asian
- For women only:
- Menopause before age 40
- Pregnancy-related high blood pressure, pre-eclampsia, eclampsia
- Gestational diabetes
The more risk factors you have, the greater your risk for heart attack or stroke. You and your healthcare team will discuss all your risk factors.
You have the power to make changes to improve your health. Learn more about Healthy Lifestyles to Manage Cholesterol
Sometimes diet and exercise are not enough to improve your cholesterol or lower your risk for heart attack or stroke. Your health care team may prescribe one or more types of cholesterol-lowering medicine. Taking these medicines can be lifesaving.
Who May Benefit from Taking Cholesterol-Lowering Medicine?
Medicines may be recommended if you:
- Had a heart attack or stroke
- Had an angioplasty, stent, or heartbypass surgery due to blockages in your arteries
- Have LDL of 190 or higher
- Have type 2 diabetes, and are between ages 40 and 75
- Are between 40 and 75 and your risk of having a heart attack
or stroke in the next 10 years is above a certain level using a
In some cases, medicine may be right for you even if you are
not in one of these groups. Talk with your healthcare team.
Helpful Tips for Lowering Cholesterol
- There are many types of medicines used to treat cholesterol. Ask your nurse or doctor to explain how your medicines work.
- Some people need more than one cholesterol medicine to reach their goals.
- Find out if there are side effects that you should know about.
- Ask if you have any concerns about how your medicines work together.
- Let your nurse or doctor know if you have concerns about the cost of your medicines.
Get the Most out of Your Medicines
Ask your healthcare team to explain how your medicines work
and any possible side effects. After 4 to 6 weeks of taking
cholesterol medicines, your healthcare provider may order blood
tests. These tests make sure the medicines are working and are safe.
- It is very important to take your medicines as prescribed.
- Don’t stop taking your medicines, or take anything new, unless you talk to your health care provider.
- Ask when to take your medicines. Is it with a meal, in the morning, or at night?
- Always use a weekly pill box, even if you only take one medicine a day. This will help you keep track. You may want to use an alarm or app to track when to take your medicines.
- Write down your medicines and always carry this list with you. Show this list to your healthcare provider at every visit.
- Write on your calendar when to refill your medicine.
- Plan ahead so you don’t run out. See if your insurance plan allows for a 90-day supply of your prescription medicines.
- If you feel bad after taking a medicine, talk with your health care team.
Healthy Lifestyle to Manage Cholesterol
Tips to Manage Your Cholesterol
Eat Healthy Foods
When you choose healthy foods, you can help make all of your cholesterol numbers better and reduce your risk of a heart attack or stroke. What is good for your cholesterol also helps improve your blood pressure. A healthy diet
may also reduce your risks for certain types of cancer. The right choices can improve your health. Here are some reliable sources to help you make healthy food choices:
Plan for Healthy Eating
- Eat several servings of vegetables and fruit every day. Try to include a variety of colors.
- Choose fiber-rich whole grains. Look for foods like whole wheat bread, brown rice, and oatmeal.
- Eat fish at least 2 times a week. Choose fatty fish like salmon, sardines, and trout.
- Eat healthy fats:
- Choose good fats such as those in foods like fatty fish, vegetable oils, avocados, and nuts.
- Limit bad saturated fats found in foods like fatty meats, whole milk, butter, ice cream, and cheese.
- Don’t eat trans fats found in foods that include baked goods, snack foods, and fast foods.
- Cut down on processed foods, salt, added sugars, and portion sizes. This is even more important if you are overweight, have high blood pressure or have high blood sugar.
- Limit soda, sports drinks, fruit juices, and alcohol. Drink water, skim milk, or low-fat milk instead.
- Record what you eat and drink on a paper log or smartphone
app, even for just a few days. This is one of the best ways to stay
Watch Your Weight
Losing weight helps lower your LDL, the bad cholesterol, and triglycerides. It can also raise your HDL, the good cholesterol. Weight loss may also lower blood pressure and blood sugar.
Aim for a Healthy Weight
Ask your nurse, doctor, or dietitian what a healthy weight is for you. Each and every pound you lose is a step in the right direction.
Tips for Losing Weight
- Step on a scale at least once a week to keep track of your weight. Write it down.
- Fill up on fiber-rich foods like vegetables, fruits, and beans. Try to eat a vegetable or fruit at every meal.
- Start your day with breakfast. Don’t skip it!
- Eat smaller portions by using smaller plates. Share meals when eating out.
- Limit alcohol and sugary drinks to reduce calories.
- Save sweets for special occasions.
- Include activity most days. The more you move, the more you lose. It may take up to 60 to 90 minutes of activity during your day to lose weight.
- Write down or use a smartphone app to track your food and activity
Any amount of physical activity is helpful. Move more and sit less. The more active you are, the more you can improve your cholesterol and other risk factors. Activity helps prevent heart attack and stroke by:
- Burning calories to help you lose weight
- Lowering your blood pressure
- Lowering your blood sugar
- Reducing stress, depression, and anxiety
Being more active also improves strength, balance, and fitness and gives you more energy. Activity may help reduce your risk of certain types of cancer and also reduces your risk of developing memory problems.
Your Activity Plan
- Choose an activity that you like. Walk, bike, swim, dance or hike
- Exercise with a friend or family member, or join an exercise class.
- Warm up and stretch before you are active. Cool down and stretch afterward.
- Perform your activity at a comfortable pace.
- Aim for 30-60 minutes of activity each day. You can break it up into 10-15 minutes at a time. Some activity is better than none!
- Add muscle-strengthening exercises twice each week. Lift weights or do push-ups.
- Use a pedometer, activity tracker or smartphone app to see
how much exercise you are getting each day.
Disclaimer: While PCNA strives to provide reliable, up-to-date health information, this and other PCNA education materials are for informational purposes only and not intended as a substitute for professional medical care. Only your healthcare provider can diagnose and treat a medical problem.