High Cholesterol: What Are Your Risk Factors?
Medically reviewed by L. Anderson, PharmD Last updated on Apr 19, 2019.
What Factors Affect Your Blood Cholesterol Levels?
Have you been struggling to lower your cholesterol without medications but are running out of luck? Many factors determine whether your blood cholesterol level is too high. Some risk factors you can't change, but many you can.
Here, you can take a look at your high cholesterol risk factors to see if you can adjust any of your lifestyle habits. With diligence, you may be able to lower your cholesterol numbers by 10% or more with a few changes in your daily routine.
Lifestyle changes you can make to help lower cholesterol
> Diet: Diet is one of the top changes you can make, in addition to weight loss. Not all fat is bad for you. However, there are components in the foods you eat that can increase your blood cholesterol level: saturated fat, trans fat and cholesterol. Saturated fat raises your cholesterol level more than anything else in the diet. Reducing the amounts of saturated fat and cholesterol you eat is an important step in reducing your blood cholesterol levels. Eating too much of the "bad" fats can elevate your risk for heart disease.
- Saturated fat is a type of fat found mostly in foods that come from animals. Items with saturated fat include red meat, poultry and high fat dairy products. Saturated fat can raise your LDL, or "bad" cholesterol.
- Trans fats (partially hydrogenated oils) raise your bad (LDL) cholesterol levels and lower your good (HDL) cholesterol levels and can be found in margarines, fried foods, and commercially prepared baked goods like cake and donuts.
- Cholesterol comes only from animal products, such as eggs, meat, and cheese. Egg consumption is controversial. Some studies show that egg consumptions does not affect heart disease risk factors, while other -- especially in patients with diabetes -- suggest eggs can worsen heart health. Talk to your doctor about egg consumption based on your level of risk factors.
> Weight: Excess weight tends to increase blood cholesterol levels. If you are overweight and have high blood cholesterol, losing weight may help you lower it.
> Exercise: Regular physical activity may help to lower LDL-cholesterol and raise desirable HDL-cholesterol levels. There is no medicine for raising HDL cholesterol that has been proven in studies to lower the risk of heart attacks and strokes.
> Alcohol: Alcohol intake may increase HDL-cholesterol, your "good" cholesterol.
- Some studies suggest a modest amount of alcohol -- especially red wine -- may be beneficial for the heart. Modest usually means no more than one drink per day for women and men over 65 years and two drinks per day for men under 65 years of age.
- Drinking too much alcohol can damage the liver and cause other health problems. Because of these risks, you should not start drinking alcoholic beverages solely to prevent heart disease if you do not already drink.
> Stress: Over the long term, stress has not been shown to raise blood cholesterol levels. The real problem with stress may be how it affects your habits.
- For example, when some people are under stress they console themselves by eating fatty foods.
- The saturated fat and cholesterol in these foods probably cause higher blood cholesterol, not the stress itself.
Factors You Can't Change That Can Lead to High Cholesterol
There are some things you simply can't control. In fact, some people who work very hard to lower their cholesterol levels, or even take potent medications to lower cholesterol, still may have high results.
> Family history and genetics: Your genes partly determine the amount of cholesterol your body makes, and high blood cholesterol can run in families.
- Unfortunately, nothing can be done to adjust your genes, but awareness of high cholesterol in your family can help you to be more vigilant in your lifestyle habits and medical check-ups.
- Be sure to alert your doctor to your family history of high cholesterol or heart disease.
- Risk is increased in those with a family history of early heart disease (heart attack or sudden death): younger than 55 years for men and younger than 65 years for women.
- Some people may have a greater risk for heart disease due to genetics that make them prone to very high cholesterol levels.
> Age and gender: Before menopause, women have total cholesterol levels that are lower than those of men the same age.
- In general. the risk for heart disease increases as you age.
- Risk is increased in men aged 45 years and over, and in women aged 55 years and over. Men, at all ages, have a higher risk for heart disease than women.
- Pregnancy raises blood cholesterol levels in many women, but blood cholesterol levels should return to normal about 20 weeks after delivery. As women and men get older, their blood cholesterol levels rise.
- In women, menopause often causes an increase in their LDL-cholesterol levels.
Other Risk Factors for Heart Disease
While high blood cholesterol (high total cholesterol and high LDL-cholesterol) and low HDL cholesterol are significant risk factors for heart disease, there are also a number of other contributing factors, many of which can be managed or changed:
- cigarette smoking (greater than 20 cigarettes per day) will increase your risk for a heart attack by up to 6-fold
- high blood pressure
- diabetes, both type 1 and type 2
- obesity and being overweight, weight gain
- kidney disease
- peripheral arterial disease
- physical inactivity
- family history of heart disease at young age (at age < 55 years in a father or brother, and < 65 years in a mother or sister)
- being a male
- older age in general
Another factor that influences your risk of heart disease is where your body stores excess fat. If you have an apple-shaped body with most of your fat around the stomach, you are at a greater risk of heart disease than if your body is pear-shaped, with most of your fat around your hips. Generally, men carry their fat around the stomach, whereas women carry it on the hips and thighs.
Talk to your doctor about all of your risk factors and what you can do to reduce your chance of heart disease. Often, the actions you take to control one risk factor help reduce others as well. For example, losing weight helps to reduce your blood cholesterol levels and high blood pressure, and helps to control diabetes. Regular physical activity can help you lose weight as well as improve the fitness of your heart and lungs, which also can help lower your risk of heart disease.
- Cholesterol Testing: What Do Your Results Mean?
- High Cholesterol Overview
- Your Guide on How to Lower Cholesterol
- Wilson P, Cannon C, Givens J, Downey B. Overview of established risk factors for cardiovascular disease. Up to Date. March 2019. Accessed April 4, 2019 at https://www.uptodate.com/contents/overview-of-established-risk-factors-for-cardiovascular-disease
- American College of Cardiology (ACC). Blood cholesterol management recommendations. Accessed March 19, 2019 at http://tools.acc.org/ASCVD-Risk-Estimator-Plus/#!/content/patient-split-layout/patient_cholesterol
- Rosenson M, Freeman M, Givens J. High cholesterol and lipids (hyperlipidemia) (Beyond the Basics). Up to Date. March 2019. Accessed April 12, 2019 at https://www.uptodate.com/contents/high-cholesterol-and-lipids-hyperlipidemia-beyond-the-basics.
- Third Report of the NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Circulation 2002; 106:3143.
- US Preventive Services Task Force. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;316(19):1997–2007. Accessed March 18, 2019 at doi:10.1001/jama.2016.15450
- Final Update Summary: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication. U.S. Preventive Services Task Force. November 2016. Accessed March 18, 2019 at https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/statin-use-in-adults-preventive-medication1
- American Heart Association. How To Get Your Cholesterol Tested. March 10, 2018. Accessed March 18, 2019 at https://www.heart.org/en/health-topics/cholesterol/how-to-get-your-cholesterol-tested
- Harvard Health. Cholesterol testing at home: It may be faster, but is it better? Accessed March 18, 2019 at https://www.health.harvard.edu/heart-health/cholesterol-testing-at-home-it-may-be-faster-but-is-it-better
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.