May 3, 2021

What it is and how to lower its levels

Low-density lipoprotein (LDL) cholesterol makes up most of the cholesterol in a person’s body. When a person has too much LDL cholesterol, it can build up in the walls of blood vessels, creating plaque.

Because LDL cholesterol may narrow blood vessels over time and elevate the risk of heart disease, people sometimes refer to it as “bad cholesterol.” HDL cholesterol, on the other hand, takes cholesterol to the liver for removal, rather than allowing it to accumulate in the blood vessels. As a result, people call it “good cholesterol.”

This article will discuss LDL cholesterol, including possible causes, factors that may increase levels, symptoms of high cholesterol, risks and possible complications, and treatment.

There are many causes of high LDL cholesterol, with some being more treatable than others.

Genes

High levels of LDL cholesterol may run in families. If there is a change in a gene relating to cholesterol, a person may develop familial hypercholesterolemia. When someone has this condition, their body struggles to remove LDL cholesterol.

The condition may affect 1 in 250 people worldwide, with 90% being undiagnosed, according to the Familial Hypercholesterolemia Foundation.

Learn more about familial hypercholesterolemia here.

Diet

If a person’s diet is high in trans fat or saturated fat, they may be at risk of elevating their LDL cholesterol. Foods high in saturated fat include fatty cuts of meat and rich dairy products.

The Department of Agriculture’s Dietary Guidelines for Americans recommends that 20–35% of an adult’s daily calories come from fats. It also recommends limiting saturated fat intake to less than 10% of calories per day, starting at age 2.

Learn more about saturated and unsaturated fats here.

Medications

Some medications may increase LDL cholesterol or decrease HDL cholesterol. These include:

Lifestyle habits

Day-to-day habits may affect LDL and HDL cholesterol levels.

  • Lack of physical activity: Doctors associate low activity levels with lower HDL cholesterol.
  • Smoking: Smoking may raise LDL cholesterol while lowering HDL cholesterol.
  • Stress: When a person feels stressed, they produce certain hormones that may cause their body to make more cholesterol.
  • Drinking too much alcohol: Binge drinking may raise cholesterol.

Health conditions

Some health conditions may increase the risk of developing high LDL cholesterol, including type 2 diabetes and obesity.

High LDL cholesterol does not necessarily present with symptoms, but a person with high LDL cholesterol levels may be at greater risk of cardiovascular disease. In addition, if someone has a history of heart attacks, angina, or stroke, a doctor may closely monitor their cholesterol.

When a doctor measures someone’s cholesterol, they will check to see if LDL levels are high and HDL levels are low. They will also look at the total amount of cholesterol in the body. The table below shows recommended levels.

Most adults should check their cholesterol every 4–6 years. People with underlying health conditions may need a cholesterol checkup more often.

According to the Centers for Disease Control and Prevention (CDC), people can lower their LDL cholesterol by taking the following actions.

Making healthy food choices

A person can prevent their LDL cholesterol from getting too high by eating foods low in saturated fat and avoiding tropical oils, such as palm oil, when cooking. They can also choose high-fiber foods to increase HDL cholesterol while lowering LDL cholesterol.

Learn more about high-fiber foods here.

Taking time to stay active

If a person is not at a moderate weight or has obesity, they may have an increased risk of high LDL cholesterol. If a person is not very active and has a high body mass index (BMI), they may need to increase their activity levels.

Adults should aim to complete 150 minutes of physical activity a week. A weekly routine may include 30 minutes of exercise over 5 days. A person could try cardio, for example, such as brisk walking or running. Muscle-strengthening activities such as hill walking or resistance weight training may also help with maintaining moderate weight levels.

Learn more about the physical and mental benefits of exercise here.

Stopping smoking

Smoking has numerous detrimental effects on the body. However, its effect on the cardiovascular system may increase the risk of heart disease in a person who already has high LDL cholesterol.

Learn more about the health effects of smoking here.

Reducing alcohol consumption

When a person drinks alcohol, their cholesterol and triglyceride levels increase. Males should not consume more than two drinks per day. Females should limit themselves to one drink per day.

Learn more about the health effects of alcohol here.

Treatment for high LDL cholesterol may differ depending on a person’s individual cholesterol levels. Prescribed medications may include:

  • Statins: This medicine slows the production of cholesterol in the liver. It also helps the liver break down cholesterol.
  • Bile acid sequestrants: This medicine removes bile acids, which prompts the body to make bile acids from LDL cholesterol.
  • Niacin: This B vitamin raises HDL cholesterol while lowering LDL cholesterol.
  • Fibrates: This medicine lowers triglycerides.
  • PCSK9 inhibitors: People who receive this medicine have familial hypercholesterolemia.

Conditions that high LDL cholesterol may contribute to include:

Several risk factors may be linked with high LDL cholesterol, including family history, age, gender, and health conditions, and behaviors.

Family history

Shared genes, together with environment and lifestyle, may influence a person’s risk of increased LDL cholesterol levels, along with other conditions such as heart disease.

Age and gender

As people get older, cholesterol naturally builds up as the body is no longer as efficient at clearing it. In general, males have lower levels of HDL cholesterol, and females have lower levels of LDL cholesterol until they reach menopause or are about age 55.

Health conditions

Health factors that could increase LDL cholesterol include:

  • previous high LDL cholesterol
  • type 2 diabetes
  • obesity
  • familial hypercholesterolemia

Behaviors

Certain behaviors may also increase the risk of developing high LDL cholesterol, such as not being active or eating foods high in saturated and trans fats.

If a person is concerned their LDL cholesterol may be too high, they should speak with their doctor.

If a person’s LDL cholesterol is too high, they may develop atherosclerotic plaque in their blood vessels, which over time can cause cardiovascular disease. People sometimes refer to LDL cholesterol as “bad cholesterol” and HDL cholesterol as “good cholesterol.” HDL cholesterol transports cholesterol to the liver, where it breaks down.

People can reduce their LDL cholesterol with exercise and eating foods low in saturated and trans fats. Foods rich in fiber can also help increase HDL cholesterol. Sometimes people inherit a gene that causes high LDL cholesterol, so it is important they avoid fatty foods and remain active.

High levels of LDL cholesterol could lead to conditions such as heart attack, stroke, and angina. If someone is concerned about their cholesterol levels, they should get in touch with their doctor.