High cholesterol

How we measure and treat this common condition

Cholesterol is a type of fat in your blood that the body needs to build cells. However, when there is too much cholesterol in your blood, it can build up in the walls of the arteries. This can cause the arteries to harden and narrow, known as atherosclerosis, making it difficult for blood to flow through the body.

High cholesterol, also known as hypercholesterolemia, by itself does not cause symptoms, so you may not know your cholesterol is high. But if the artery becomes completely blocked, it can result in a heart attack or stroke.

In rare cases, high cholesterol can be caused by an inherited genetic mutation (familial hypercholesterolemia), but more often, it’s the result of unhealthy lifestyle choices.

Tests

We measure cholesterol with a simple blood test done after a nine- to 12-hour fast. The test tells us about your:

  • Total cholesterol
  • LDL (bad) cholesterol, the main source of blockage in the arteries
  • HDL (good) cholesterol, which helps keep cholesterol from building up and protects against heart disease
  • Triglycerides, another type of fat in your blood

Cholesterol is measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. Optimal levels for people without other health conditions are:

  • Total cholesterol: Less than 200 mg/dL
  • LDL (bad) cholesterol: Less than 100 mg/dL
  • HDL (good) cholesterol: Above 60 mg/dL
  • Triglycerides: Less than 100 mg/dL

Treatments

Making healthy lifestyle changes often is the first line of defense against high cholesterol. This can include:

  • Eating a heart-healthy diet
  • Exercising regularly
  • Maintaining a healthy weight

If making these lifestyle changes isn’t enough to lower your cholesterol, your doctor may recommend medication, such as statins, bile acid sequestrants, or cholesterol absorption inhibitors.

Lipid disorders

Lipid disorders develop when fatty substances build up in the blood. These substances include cholesterol and triglycerides.

Left untreated, these buildups, commonly known as high cholesterol and high triglycerides, can lead to many other health problems, including high blood pressure and atherosclerosis (hardening of the arteries). They can also increase risk for heart disease and stroke.

At MedStar Health, our team of endocrinologists work with patients to manage lipid disorders, and coordinate care with other medical specialists, including cardiologists and vascular surgeons.

Among the lipid disorders we treat are:

  • Hypercholesterolemia: High levels of cholesterol in the blood
  • Hypertriglyceridemia: High levels of triglycerides in the blood

Treatment

Hypercholesterolemia: Lifestyle changes are usually the first line of treatment and include:

  • Eating a heart-healthy diet that includes fiber-rich fruits and vegetables and avoids saturated fats, fast foods, and commercially baked products
  • Exercising regularly
  • Losing weight, if you are overweight
  • Quitting smoking

There are a variety of medication options available to help lower cholesterol when diet and exercise are not enough. We will work with patients to prescribe a medication that will be most effective.

Hypertriglyceridemia: Conditions like obesity, diabetes, and hypothyroidism can lead to hypertriglyceridemia. Treatment starts by getting these underlying problems under control. We also recommend making lifestyle changes that include:

  • Avoiding alcohol
  • Eating a healthy diet that avoids excess calories and foods high in saturated fats and carbohydrates
  • In some cases, medication is prescribed to help keep triglyceride levels under control, including statins and newer agents that are called PCSK9 inhibitors.

Our locations

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MedStar Washington Hospital Center

110 Irving St. NW
Washington, DC 20010

MedStar Health: Medical Center at Chevy Chase

5454 Wisconsin Ave. Barlow Building
11th Fl.
Chevy Chase, MD 20815

MedStar Health: Medical Center at Mitchellville

12158 Central Ave.
Mitchellville, MD 20721

MedStar Montgomery Medical Center

18101 Prince Philip Dr.
Olney, MD 20832

MedStar Health: Lafayette Centre - Building 2

1133 21st St., NW
Building 2
Washington, DC 20036

Read our Cardiovascular Performance & Outcomes Booklet

Ask MHVI

Have questions for our heart and vascular specialists? Email us at AskMHVI@medstar.net