Cholesterol: How to Check It, Lower It, and Reduce Heart Risk

Most people with high cholesterol feel fine — until a heart attack or stroke shows up. Cholesterol itself isn't the enemy: your body needs it. But too much LDL (the "bad" kind) or low HDL (the "good" kind) raises the risk of clogged arteries. This page gives clear, no-nonsense steps you can use now.

Quick tests and target numbers

A standard lipid panel measures total cholesterol, LDL, HDL, and triglycerides. Here are common targets used by doctors: total cholesterol under 200 mg/dL, LDL under 100 mg/dL for most people (under 70 mg/dL if you have heart disease), HDL over 40 mg/dL for men and over 50 mg/dL for women, and triglycerides under 150 mg/dL. If your LDL is above 190 mg/dL or you have diabetes, family history, or prior heart disease, your doctor will treat more aggressively.

Doctors also use a 10-year risk score to decide on medicines. That score combines age, blood pressure, smoking, diabetes, and cholesterol numbers. Don’t guess — ask your clinician for the risk estimate and what it means for you.

Practical ways to lower cholesterol

Start with diet: eat more soluble fiber (oats, beans, apples), add plant sterols (fortified spreads or certain supplements), choose nuts and fatty fish, and swap butter for olive oil. Cut trans fats completely; limit saturated fats from fatty cuts of meat and full-fat dairy. Small shifts matter — replacing a couple of high-fat meals per week makes a difference.

Move your body. Aim for about 150 minutes of moderate aerobic activity per week (brisk walking, cycling). Losing even 5-10% of body weight often improves LDL and triglycerides.

Medication is common and effective. Statins are first-line: they lower LDL and reduce heart attacks. Ezetimibe or bile acid sequestrants can be added if statins aren’t enough. For very high-risk patients, PCSK9 inhibitors (injectable) can cut LDL a lot. Common statin issues include muscle aches and rare liver enzyme changes; doctors usually check blood tests 4–12 weeks after starting therapy and then periodically.

Watch interactions: grapefruit juice can raise levels of some statins (like simvastatin and atorvastatin) — avoid mixing without medical advice. Tell your doctor about all medicines and supplements.

Check your numbers regularly: after lifestyle changes or new medicines, re-test to see progress. If you have strong family history of early heart disease, or sudden chest pain, contact your doctor right away. Pick one change this week — swap a processed snack for fruit, add a 20-minute walk, or book a cholesterol test. Small steps add up and protect your heart.