Lower "Bad" LDL Cholesterol While Raising "Good" HDL Cholesterol

Angela Ryan Lee, MD
·5 min read
28
<p>Oscar Wong / Getty Images</p>

Oscar Wong / Getty Images

Medically reviewed by Danielle Weiss, MD

Cholesterol is a fatty substance found in the blood that the body needs for certain functions, but abnormal cholesterol levels can cause problems. Cholesterol is carried in the blood in particles of fat and protein called lipoproteins, like low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL is often called "bad" cholesterol since high levels are strongly linked to cardiovascular disease.

Cholesterol is made in the liver, but we also get it from certain foods, like meat, seafood, and dairy. While genetics plays a big role in our cholesterol levels, there are some things we can do to change our levels. Read on to learn more about cholesterol, its role in disease, and how to lower LDL and risk.

<p>Oscar Wong / Getty Images</p>

Oscar Wong / Getty Images

Why LDL Is "Bad" Cholesterol

Cholesterol is carried in lipoproteins in the blood. These particles carry cholesterol inside, and they have certain proteins on the surface that determine where the cholesterol goes.

Low-density lipoprotein is considered "bad" cholesterol because it causes atherosclerosis, the buildup of plaque in the walls of arteries. Atherosclerosis is responsible for problems like heart attacks and strokes.

High-density lipoprotein on the other hand, is considered "good" cholesterol because it brings cholesterol on a path back to the liver, where the body can get rid of it.

Conditions Linked to High LDL Cholesterol

High LDL is part of a condition known as dyslipidemia, which is also known as hyperlipidemia or hypercholesterolemia. It's commonly seen in the following conditions:

Dyslipidemia causes atherosclerosis, which can affect blood vessels throughout the body. In atherosclerosis, there is buildup of fatty plaques in the arteries that can cause narrowing and impair blood flow. Sometimes the plaques can rupture and cause an abrupt blockage. Atherosclerosis is involved in the following conditions:

  • Coronary artery disease, which causes heart attacks

  • Carotid artery disease and intracerebral atherosclerosis, which can cause strokes

  • Peripheral artery disease which can cause leg pain (claudication), poor blood flow and wound healing problems, and infections that may require amputation

  • Mesenteric ischemia that can cause abdominal pain, bowel damage, perforation, and infection

  • Renal artery stenosis, which can cause kidney disease and high blood pressure

LDL Ranges: Healthy Levels to Aim For

Studies show that lowering LDL decreases your risk of heart disease and stroke. The goal LDL level depends on your individual situation. LDL goals have been a moving target over the years based on guidelines by the American Heart Association. In general, everyone should aim for an LDL level of less than 100 milligrams per deciliter (mg/dL) since this level is associated with low levels of cardiovascular disease.

However, if you have have atherosclerotic cardiovascular disease (ASCVD), such as coronary artery disease, peripheral artery disease, aortic aneurysm, or a history of heart attack, transient ischemic attacks (TIAs), or stroke, you should aim for an even lower LDL level. Your healthcare provider will prescribe cholesterol lowering therapies aiming to cut your LDL in half, and ideally less than 70 mg/dL.

Factors That Affect LDL Levels

LDL cholesterol is affected by many things, some of which we can control and others of which we cannot. For example, genetics plays a big role, though we have no control over the genes we inherit. Cholesterol also increases to some extent as we age.

Additionally, sex hormones play a role in cholesterol, with those of people assigned male at birth having higher cholesterol levels compared to people assigned female at birth. That is true until the age at which those of female sex undergo menopause, at which time their cholesterol levels increase.

Other factors that raise LDL include:

Actions to Take With High LDL Cholesterol

If you have high cholesterol, the first thing to do is have a conversation with your healthcare provider about your individual risk of cardiovascular disease. Everyone can benefit from many of the lifestyle changes that lower LDL and/or decrease cardiovascular risk. These include:

  • Get regular physical exercise: The American Heart Association recommends at least 150 minutes per week of moderate intensity exercise or 75 minutes per week of vigorous exercise.

  • Eat a heart healthy diet: This diet should be low in saturated fats, trans fats, processed foods, and salt. Instead, get lots of fiber by incorporating fruits and vegetables, whole grains, nuts and legumes. Eat fish high in omega-3 fatty acids like salmon or tuna.

  • Quit smoking.

  • Limit alcohol intake.

  • Control stress levels.

  • Get adequate sleep.

In addition to lifestyle changes, many people need cholesterol-lowering medication to treat high cholesterol and lower their risk of future heart attack or stroke. Statins are the main medication used to treat high cholesterol, and several other medications may be prescribed.

How Often to Test LDL Levels

Most healthy people should have their cholesterol checked about every five years. If you have high cholesterol or other risk factors for cardiovascular disease, your healthcare provider may recommend annual screenings. Sometimes, more frequent testing is needed, such as after adding or changing cholesterol medication.

Summary

Cholesterol is necessary in our bodies, but too much cholesterol can cause problems and increase the risk of heart disease, stroke, and other complications. LDL is considered "bad" cholesterol since it is strongly linked to atherosclerosis. While genetics, age, and sex play a role, there are ways that we can lower our LDL levels. Eating a heart-healthy diet, quitting smoking, and getting regular physical exercise are steps to take to not only lower your LDL but improve your overall health.