If left untreated, high cholesterol can lead to high blood pressure and other heart problems.Getty Images; Everyday Health
Low-density lipoprotein (LDL) cholesterol is the most common type of cholesterol found in your blood. Each LDL particle is made up of a lipoprotein coat and a cholesterol center.
Although it’s often known as the “bad” cholesterol, LDL cholesterol isn’t inherently unhealthy. Your body needs LDL cholesterol to protect nerves and produce cells and hormones.
High-density lipoprotein (HDL) cholesterol is the other type of cholesterol, and is often called “good” cholesterol. Both LDL and HDL cholesterol are produced in the liver.
At higher levels, LDL cholesterol builds up as plaque in the walls of blood vessels. Over time, this buildup can result in atherosclerosis, or hardening of the arteries.
Atherosclerosis can raise your risk of heart attack, stroke, and death. When plaques form on the arteries supplying blood to your brain, abdomen, arms, and legs, they can lead to intestinal damage and peripheral arterial disease.
High cholesterol is influenced by both genetic and lifestyle factors. Approximately 20 percent of the world’s population is thought to have elevated levels of Lp(a), or lipoprotein(a), a type of LDL cholesterol. Lp(a) is a risk factor for developing arterial plaques well before the typical age of onset for heart disease.
In a 2020 observational study of more than 283,000 adults in the United Kingdom, researchers found measured Lp(a) was associated with atherosclerotic cardiovascular disease, strengthening evidence for the cholesterol variant’s clinical significance.
Since there is no specific treatment for Lp(a), it’s important for people who are carriers to keep their LDL cholesterol levels low. Unlike overall high LDL cholesterol, which generally can be managed through lifestyle changes and medication, elevated levels of Lp(a) are largely genetically determined.
The American Heart Association (AHA) does not currently recommend universal screening for Lp(a), but some physicians, like George Thanassoulis, MD, of McGill University in Montreal, now recommend getting tested since more targeted therapy for high Lp(a) is likely to come in the near future.
Although more uncommon, there is another genetic condition that causes abnormally high cholesterol: familial hypercholesterolemia, or FH. This condition, which affects about 1 million Americans, can cause elevated LDL levels early in life, which could lead to premature heart attacks if left untreated. A blood test can confirm the diagnosis, but again, the condition is relatively rare.
Testing for high cholesterol overall, however, is recommended by the AHA. Since cholesterol isn’t something that causes symptoms until a person develops heart disease or other complications, it’s important to get tested regularly via a blood test (also known as a lipid panel). Ask your physician or primary care provider on your next visit.
LDL Cholesterol Facts
Nearly 94 million adults in the United States — almost 40 percent of the population — have total cholesterol levels higher than the normal range. Slightly more than half of adults with high cholesterol are getting treatment to lower it.
A desirable LDL level is less than 100 mg/dL. A range of 100 to 159 mg/dL is considered at-risk, and 160 mg/dL or higher is considered dangerous.
