Cholesterol
Cholesterol is a waxy, fat-like substance found in the blood. The body needs cholesterol to build cells and make certain hormones and vitamins. Cholesterol also helps the body digest fats.
The liver makes most of the cholesterol in the body, and foods such as meat, eggs, and dairy products provide the rest. Because cholesterol does not mix well with blood, it travels through the bloodstream attached to particles called lipoproteins. LDL (“bad”) cholesterol carries cholesterol to the arteries, where it can build up on the arterial walls.
When LDL cholesterol levels are too high, cholesterol can collect in the arteries and increase the risk of heart and vascular disease. Understanding how cholesterol works in the body—and how clinicians manage cholesterol levels—helps protect long-term cardiovascular health.
Symptoms
High cholesterol usually doesn’t cause noticeable symptoms. Many people learn they have high cholesterol after a routine blood test during a regular health visit or after developing a related cardiovascular condition.
In some cases, people with very high cholesterol that runs in families, known as familial hypercholesterolemia, may notice physical signs. These can include fatty bumps that form under the skin, often around the elbows, joints, knees, hands, ankles, or buttocks. Some people may also develop grayish-white rings around the cornea of the eye.
For many others, high cholesterol remains silent until it leads to complications such as heart disease, heart attack, or stroke.
Causes & Risk Factors
High cholesterol develops when there is too much cholesterol circulating in the blood. Excess cholesterol can build up along artery walls and contribute to plaque formation. Several factors can raise cholesterol levels and increase the risk of heart and vascular disease.
Genetics
Genetics plays a major role in cholesterol levels. Some people inherit genes that affect how their bodies make or remove cholesterol from the blood. These inherited differences can lead to higher cholesterol levels, even with healthy habits.
In some families, a condition called familial hypercholesterolemia causes very high LDL (“bad”) cholesterol, often beginning at a young age. Familial hypercholesterolemia affects the body's ability to clear LDL cholesterol from the bloodstream, making it harder to remove it efficiently.
Diet and Lifestyle Factors
Diet and lifestyle also strongly influence cholesterol levels. Diets high in saturated fats can increase LDL cholesterol, especially in people who are already genetically susceptible.
Other factors that can raise cholesterol include:
Carrying excess body weight
Physical inactivity
Smoking
These factors can change the signals the liver uses to manage cholesterol, causing it to release more LDL cholesterol into the bloodstream than the body needs.
Health Conditions and Medications
Some health conditions can raise cholesterol levels or make cholesterol harder to manage, including:
Diabetes or other problems with blood sugar control
Thyroid disorders
Kidney disease
Liver disease
Some medications can also affect cholesterol levels, including certain steroids, hormone therapies, and medications used to manage blood pressure or immune-related conditions.
Having multiple risk factors at the same time can further raise cholesterol levels and increase the risk of heart disease and stroke.
Diagnosis
Treatment
The goal of treatment for high cholesterol is to help lower LDL (“bad”) cholesterol and reduce the risk of heart and vascular disease. Care often includes a combination of lifestyle changes and medication, based on a person’s cholesterol levels and overall risk.
Healthy Lifestyle Changes
Lifestyle changes play an important role in cholesterol management. They may be recommended for most people, whether or not medication is needed.
These changes may include:
Eating a heart-healthy diet that limits saturated fats
Being physically active regularly
Reaching and maintaining a healthy weight
Avoiding tobacco products
Medications
Sometimes, lifestyle changes alone aren’t enough to lower cholesterol. People with very high LDL cholesterol or inherited cholesterol conditions may need additional treatment.
Several types of medications can help lower cholesterol and reduce cardiovascular risk. The most commonly prescribed are statins, which lower LDL (“bad”) cholesterol. For many people, taking a statin along with healthy lifestyle changes is enough to bring cholesterol levels into a safer range. Some people may need additional medications if cholesterol levels remain high or if they don't tolerate statins well.
Procedures
Most people manage high cholesterol with lifestyle changes and medications.
When cholesterol buildup narrows or blocks arteries, clinicians may recommend procedures to restore blood flow. These procedures treat:
Narrowed arteries
Plaque-related blockages
Complications caused by long-standing cholesterol buildup
These procedures focus on improving blood flow in the arteries, while medications and lifestyle changes help lower cholesterol levels.
Living With/Prevention
Managing high cholesterol usually involves ongoing follow-up and monitoring. Ongoing care may include regular blood tests to track cholesterol levels and check how well treatment is working.
Clinicians may adjust treatment plans based on how cholesterol levels respond to lifestyle changes or medications, as well as any side effects or changes in overall health. Managing related conditions—such as high blood pressure or diabetes—can also help reduce cardiovascular risk.
Take Control of Your Heart Health
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Centers for Disease Control and Prevention. Risk factors for high cholesterol. Updated May 15, 2024. Accessed February 12, 2026.
American Heart Association. Cholesterol medications. Reviewed February 20, 2024. Accessed February 12, 2026.
National Heart, Lung, and Blood Institute. Symptoms. Updated April 18, 2024. Accessed February 12, 2026.
Rosenzweig JL, Bakris GL, Berglund LF, et al. Primary prevention of ASCVD and T2DM in patients at metabolic risk: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2019;104(9):3939-3985. doi:10.1210/jc.2019-01338
Virani SS, Newby LK, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2023;82(9). doi:10.1016/j.jacc.2023.07.002
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