Since high cholesterol has no symptoms, the only way to detect it is by getting a blood test.

High cholesterol occurs when too much of one type of cholesterol (LDL) builds up in the walls of your arteries. The hardening of the arteries that results is known as atherosclerosis, and it restricts blood flow to your heart and brain.

Without treatment, it may eventually cause a heart attack, stroke, or other health issues.

High cholesterol is one of the most common chronic conditions in the United States; more than 73 million people have it. The good news is most people can significantly lower their LDL cholesterol by adopting healthier eating habits.

Risk factors

Some people are predisposed to high cholesterol due to inherited risk factors. Having a family history of high cholesterol is one of them. Age (over 45 years for men and over 55 years for women) is another. Other existing conditions, such as diabetes and high blood pressure, gender, and race, may also make you more susceptible to high cholesterol.

Lifestyle also plays a role. Diets high in saturated fat, trans fat, cholesterol, sodium, and sugar, and smoking, inactivity, and being overweight or obese increases the likelihood of high cholesterol. Fortunately, these are manageable.

Know your numbers

Starting at age 20, you should get a blood test, specifically a cholesterol test or lipid panel, to check for high cholesterol, every five years. If a test detects high cholesterol, your doctor will recommend more frequent testing, as often as every three months, until your results are desirable. Once the normal cholesterol levels are reached, you should test annually.

A cholesterol reading consists of four numbers. Here are the recommended levels for each.

• Total cholesterol: <200 mg/dL
• HDL: >50 mg/dLx
• LDL: <70-130 mg/dL
• Triglycerides: <150 mg/dL

If your results are higher than normal, your doctor may recommend other tests, such as a blood sugar (glucose) test to check for diabetes, as well as kidney function tests, and thyroid function tests to check for an underactive thyroid gland.

Warning symptoms

No symptoms surface for people with high cholesterol levels. However, if you experience any of the following, get medical help immediately, as it may be a health emergency:

• Tightness or pain in the chest, abnormal heartbeat, lightheadedness, fatigue, anxiety, and other symptoms of a heart attack
• Paralysis or numbness, problems with coordination, stiff muscles, inability to speak or understand, and other symptoms of a stroke

Finding the right care

Start by seeing your primary care doctor.

After diagnosis, plan to have regular checkups with your primary care doctor at least once every three months for blood tests until you meet the ideal cholesterol levels.

After you meet your cholesterol goals, schedule checkups annually. Your primary care doctor will monitor risks regularly, help detect patterns, and alert you to any changes. Checkups will also show you if the changes you’ve made are working, or if you both will need to reassess your treatment options.

If you’re having trouble keeping your cholesterol at your goal level, especially if you’re taking more than two cholesterol medications, ask your primary care doctor if you should also see one of these types of specialists:

• An endocrinologist to help you manage diabetes associated with high cholesterol
• A cardiologist to help you manage heart disease associated with high cholesterol

Choosing a treatment plan

Lifestyle changes are key, but some people also need medications to keep cholesterol in check.

Healthy lifestyle habits can help you control high cholesterol

• Healthy eating. Avoid foods with high cholesterol and fat, especially saturated and trans fats. Eating foods that are low in sugar and sodium also helps.
• Exercise regularly and maintain a healthy weight. Aerobic exercise, such as brisk walking, is recommended five times per week for at least 30 minutes.
• Quit smoking. If you smoke, cutting out this habit may be the single best thing you can do for yourself to reduce your risk of getting a heart attack or stroke.