Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 1998;57(9):2207-2208

See related article on dyslipidemia.

What are lipids?

Fats in the blood are called lipids. Lipids join with protein in your blood to form lipoproteins. Lipoproteins make energy for your body, so they're important to the cells in your body.

Three kinds of lipoproteins, (also called cholesterol), re in your blood: (1) high-density (also called HDL, for short) cholesterol, (2) low-density (also called LDL) cholesterol and (3) very low-density (VLDL) cholesterol. HDL is sometimes called the “good cholesterol” because it keeps cholesterol from buiding up in your arteries. (You can remember this is the “good” cholesterol if you think “H is for healthy.”) LDL can be thought of as the “bad” cholesterol because high LDL levels can increase your risk of heart attack or stroke. (You can remember this is the “bad” cholesterol if you think “L is for lousy.”)

What is a normal total cholesterol level?

A normal total cholesterol level is 200 mg per dL or less.

What is a normal LDL level?

A normal LDL level is 130 mg per dL or less. When the LDL level is higher than 130, fat can build up in the walls of your blood vessels. This fat can plug up your arteries and keep the blood from flowing through them. If an artery going to your heart gets blocked, you might have a heart attack. If an artery going to your brain gets blocked, you might have a stroke. A high LDL level causes heart disease, stroke, poor circulation and kidney disease.

What causes high levels of fat in the blood?

Most people have high levels of fat in their blood because they eat too much high-fat food. Some people have high fat levels because they have an inherited disorder. High lipid levels may also be caused by medical conditions such as diabetes, hypothyroidism, alcoholism, kidney disease, liver disease and stress. In some people, certain medicines, such as birth control pills, steroids and blood pressure medicines, can cause high lipid levels.

When should I have my cholesterol level checked?

If you're over 20 years of age, you should have a blood test to measure your cholesterol. If your cholesterol level is high, your doctor will recommend treatment and will recheck your cholesterol every so often.

Are there any signs of high cholesterol levels?

Often there are no signs. Without a blood test, you may not know you have high levels of fat in your blood until you have a heart attack or a stroke. Some people with high lipid levels have yellowish, fatty bumps on their skin.

What is the treatment for high lipid levels?

The first ways to reduce your lipid levels are (1) eat less fat, (2) exercise regularly and (3) lose weight if you weigh too much. If you smoke, stop smoking. If these steps don't lower your LDL level enough, your doctor may have you take medicine to take the fat out of your blood.

What are some ways to cut down on fat in my diet?

  • Buy lean cuts of meat. Cut away all visible fat before cooking it.

  • Remove the skin from chicken before cooking it.

  • Don't eat fried foods or high-fat sauces.

  • Instead of frying meat, broil it or grill it.

  • Don't eat egg yolks. You can eat egg whites or egg substitutes.

  • Use low-fat dairy products, such as skim milk or 1% milk, low-fat frozen yogurt, low-fat ice cream and low-fat cheeses.

  • Don't use whole milk, full-fat ice cream, sour cream, cheese or milk chocolate.

  • Put more fiber in your diet. Fruits and vegetables are good sources of fiber. Eat three to five servings of vegetables a day and two to four servings of fruits.

What about exercise?

Aerobic exercises, such as walking, running, bicycling and swimming, are a good way to lower your blood cholesterol. Exercise also lowers your blood pressure, your blood sugar level and your stress level. If you weigh too much, aerobic exercise helps you burn calories. That will help you lose weight. Aerobic exercise should be done on a regular basis: work up to exercising for 30 minutes at a time four or five times a week. You can also exercise for a shorter time, such as 10 to 15 minutes. But if you exercise for only 10 to 15 minutes at a time, you need to exercise more often than four or five times a week.

What about cholesterol-lowering medicine?

Medicines to lower your cholesterol level may be used if you are at high risk for heart disease or if your lipid levels don't drop after you have eaten a low-fat diet for a couple of months.

There are different kinds of medicine that lower cholesterol. You may need to take just one medicine or you may need to take more than one, depending on how high your cholesterol is. Your doctor will take blood tests every so often to check on your cholesterol level and find out if the medicine is working.

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