The CDC educates the public on preventing high cholesterol and reducing chronic disease risk during National Cholesterol Education Month in September.
At a physician’s visit, one of the most dreaded phrases for many patients is: ‘high cholesterol.” Cholesterol often gets a bad reputation, but not all cholesterol is bad; some types are essential for good health.
Cholesterol is a waxy, fat-like substance carried throughout the bloodstream. The body needs cholesterol to make hormones and build cells, according to the Centers for Disease Control and Prevention (CDC).
Two types of cholesterol travel through the body on proteins called lipoproteins; low-density lipoprotein (LDL), sometimes called “bad” cholesterol, and high-density lipoprotein (HDL), or “good” cholesterol, according to the CDC.
HDL carries cholesterol back to the liver, and the liver flushes it from the body. When the body has levels of LDL cholesterol that are too high, it can build up in the walls of blood vessels (known as plaque) and prevent the proper flow of blood. LDL cholesterol is a major risk factor for cardiovascular disease (CVD).
As the blood vessels build up more plaque over time, the inside of the vessels narrow. This narrowing can restrict and eventually block blood flow to and from the heart and other organs. When blood flow to the heart is blocked, it can cause serious health issues including heart disease, angina (chest pain), heart attack and stroke.
From 2017 to 2020, nearly 86.4 million U.S. adults aged 20 or older had high or borderline high cholesterol (a total cholesterol level greater than or equal to 200 mg/dL), according to the CDC. An optimal cholesterol reading, according to the CDC, is around about 150 mg/dL.
Understanding and preventing high cholesterol
There are usually no warning signs when a person has high cholesterol. Many people do not know that their cholesterol levels are too high until they have a heart attack or stroke.
For this reason, it is very important to take the necessary steps to manage cholesterol levels before it is too late.
Fortunately, there are numerous preventative measures and lifestyle changes that can be made to maintain a healthy cholesterol level.
One significant way for people to manage cholesterol is through proper nutrition and diet modifications. Foods with a lot of cholesterol usually also have high levels of saturated fat, and saturated fats can make cholesterol levels higher. Specifically, food that is made from animals, including red meat, butter and cheese often has a lot of saturated fat.
To prevent the buildup of cholesterol, those at risk should aim to eat foods with plenty of fiber, such as oatmeal and beans, and healthy unsaturated fats, such as avocados, olive oil, and nuts.
Being active everyday also can help to lower cholesterol levels. The Physical Activity Guidelines for Americans, from the U.S. Department of Health and Human Services, recommends that adults get 150 to 300 minutes of moderate physical activity each week.
Keeping up with cholesterol levels
The only way to know for sure whether you have a high level of cholesterol is to get it checked at a physician’s office. A cholesterol test is a blood test measuring the amount of cholesterol and triglycerides (type of fat) in the blood.
The CDC recommends that healthy adults get their cholesterol level checked at least every three to five years. People who have heart disease, diabetes, or a family history of high cholesterol should ensure they get their cholesterol checked more often.
Children should also be aware of their cholesterol levels, as early monitoring can prevent more serious future health issues. About 1 in 5 adolescents had an unhealthy cholesterol measurement from 2009 to 2016, according to the CDC.
Children should have their cholesterol checked at least once between ages 9 and 11, and adolescents should have their cholesterol checked between ages 17 and 21. Children who have obesity or diabetes may need to be screened for high cholesterol more often.
Patients should know their family history of cardiovascular disease and talk with a healthcare team about ways to manage cholesterol, according to the CDC. The 2018 American College of Cardiology/American Heart Association Guidelines recommend that cholesterol management be based on a person’s lifetime cardiovascular risk, whether a person is 45 to 75 years of age, has diabetes, or if other health factors may impact risk.
Healthcare professionals can calculate a person’s lifetime cardiovascular risk by considering comorbidities, whether a person is being treated for high blood pressure, whether a person smokes and more.
High cholesterol awareness
In some cases, elevated cholesterol isn’t just the result of diet or lifestyle, it also may be inherited.
As many as 1 in 212 U.S. adults may have a genetic condition called familial hypercholesterolemia (FH), an inherited disorder that causes the liver to have problems metabolizing and removing excess LDL cholesterol, resulting in very high LDL levels, according to Million Heart’s Cholesterol Management page.
Some people, including those with FH, need medicine, called statins, to manage their cholesterol. Statins work in the body by reducing the production of cholesterol in the liver. Data from 2013–2014 indicate that only about half (54.5%) of U.S. adults (over age 21) who might benefit from statin use are taking them, according to Million Hearts.
Statins, when used as indicated for most patients, can dramatically reduce a person’s risk of having a heart attack or stroke, according to the Million Hearts Initiative. It is essential that if patients are given statins to manage cholesterol that they take them exactly as prescribed to ensure the best outcome.
To raise awareness about the importance of the proper management of cholesterol, The CDC recognizes National Cholesterol Education Month in September to educate the public.
The CDC’s website has social media and graphics available to the public, physicians and healthcare organizations to help spread the word about what cholesterol is and why managing it is important to reducing cardiovascular disease.
With the support of health professionals, CDC’s Division for Heart Disease and Stroke Prevention (DHDSP) also educates the public about cholesterol management through the Cholesterol Communications Toolkit.