High Blood Cholesterol
You may be diagnosed with high blood cholesterol if you consistently have high levels of bad cholesterol in your blood in a routine test called a lipid panel. To treat high blood cholesterol, your doctor may recommend heart-healthy lifestyle changes, such as heart-healthy eating, quitting smoking, or aiming for a healthy weight. Your doctor may also prescribe medicines, such as statins, to lower and control your high blood cholesterol. Untreated high blood cholesterol can lead to the buildup of plaque in the blood vessels, called atherosclerosis. Plaque buildup increases your risk for heart attack, stroke, and peripheral artery disease.
Explore this Health Topic to learn more about high blood cholesterol, NHLBI’s role in research and clinical trials to improve health, and where to find more information.
Causes
Unhealthy lifestyle habits
Unhealthy eating patterns, lack of physical activity, and smoking can cause high blood cholesterol.
- Unhealthy eating patterns, such as consuming high amounts of saturated fats or trans fats, can increase bad low-density lipoprotein cholesterol (LDL cholesterol).
- Lack of physical activity, such as spending a lot of time during the day sitting and watching TV or using the computer, is linked with lower levels of good high-density lipoprotein cholesterol (HDL cholesterol).
- Smoking lowers HDL cholesterol, particularly in women, and increases LDL cholesterol.
Read heart-healthy lifestyle changes to learn about eating heart-healthy, being physically active, aiming for a healthy weight, managing stress, and quitting smoking.
Genes
Some people may develop high blood cholesterol because of mutations, or changes, in their genes. These mutations make it harder for the body to clear LDL cholesterol from the blood or break it down in the liver. Familial hypercholesterolemia is one inherited form of high blood cholesterol.
Other medical conditions
The following medical conditions may cause high blood cholesterol:
- Chronic kidney disease
- Diabetes
- HIV
- Hypothyroidism
- Overweight and obesity
- Polycystic ovary syndrome
- Inflammatory diseases such as psoriasis, lichen planus, pemphigus, histiocytosis, lupus erythematosus, and rheumatoid arthritis
Medicines
Some medicines that you take for other medical conditions can increase your cholesterol. Examples of these medicines include the following:
- Diuretics such as thiazide that are used for high blood pressure
- Immunosuppressive drugs such as cyclosporine that are used to treat inflammatory diseases such as psoriasis or to prevent rejection after a transplant
- Steroids such as prednisone that are used to treat inflammatory diseases such as lupus and psoriasis
- Retinoids such as retinol that are used to treat acne
- Antiretroviral medicines used to treat HIV
- Antiarrhythmic medicines such as amiodarone that are used in treatment for irregular rhythm of the heart
Look for
- Treatment will discuss heart-healthy lifestyle changes that your doctors may recommend if you are diagnosed with high blood cholesterol.
Risk Factors
You may have an increased risk for high blood cholesterol because of your age, your family history and genetics, and your race.
Age
Your body’s metabolism and chemistry change as you age. For example, your liver does not remove low-density lipoprotein (LDL) cholesterol as efficiently as when you were young. These normal age-related changes may increase your risk of developing high blood cholesterol.
Family history and genetics
Genetic studies have found that related family members tend to have similar levels of low-density lipoprotein (LDL) cholesterol, known as bad cholesterol, or high-density lipoprotein (HDL) cholesterol, known as good cholesterol. Depending on the genes in your family, you may have an increased risk for high blood cholesterol. Learn more about current research to better understand how genetic differences may affect how our bodies absorb cholesterol from the foods that we eat, how much cholesterol the liver produces and removes, and how we respond to high blood cholesterol treatments.
Race
Your race may also increase your risk for high blood cholesterol. Compared to whites, blacks have higher HDL and LDL cholesterol levels.
Levels of one type of blood fat can signal your risk of developing heart disease separately from the others. It is called lipoprotein-a, or Lp(a). Lipoproteins, including HDL and LDL, carry cholesterol in your blood. Unlike HDL and LDL, Lp(a) is not part of standard lipid panels, but your doctor can request a test for it in special cases. Genes determine how much Lp(a) you have. This level is unlikely to change much from childhood to old age. If other cholesterol measurements on your lipid panel are low, high Lp(a) could explain other signs of heart disease, especially in children, or suggest a particular treatment approach.
Screening and Prevention
Your doctors will order routine lipid panel blood tests to screen for high blood cholesterol. The timing and frequency of these blood tests will depend on your age and risk factors or family history for high blood cholesterol or other cardiovascular diseases such as heart attack or stroke. Learn about heart-healthy lifestyle changes that your doctor may recommend to help you prevent high blood cholesterol.
Lipid panel tests to check for healthy blood cholesterol levels
Doctors use lipid panels to check whether you have healthy levels of cholesterol in your blood. A lipid panel will measure the total cholesterol, high-density lipoprotein (HDL) cholesterol, and non-high-density lipoprotein (non-HDL) cholesterol levels in your blood. Non-HDL cholesterol includes low-density lipoprotein (LDL) cholesterol and is calculated by subtracting your HDL cholesterol levels from your total cholesterol levels. See the table below to learn whether you have healthy blood cholesterol levels based on your age and sex.
![Healthy blood cholesterol levels differ by age and sex. If you are age 19 or younger, your total cholesterol levels should be less than 170 milligrams per deciliter (mg/dL) of blood, your non-HDL cholesterol level should be less than 120 mg/dL, your LDL cholesterol level should be less than 100 mg/dL, and your HDL cholesterol level should be more than 45 mg/dL. If you are age 20 or older, your total cholesterol should be between 125 and 200 mg/dL, your non-HDL cholesterol level should be less than 130 mg/dL, your LDL cholesterol level should be less than 100 mg/dL, and your HDL cholesterol level should be 40 mg/dL or higher if you are a man or 50 mg/dl or higher if you are a woman.](/congress115th/20190108215144im_/https://www.nhlbi.nih.gov/sites/default/files/inline-images/17-1432_NHLBI_HT_Q1_HBP_Table1_1200px_dev5.jpg)
When you receive this screening will depend on your age, risk factors, and family history of high blood cholesterol and cardiovascular diseases such as atherosclerosis, heart attack, or stroke.
- Age 19 or younger. Screening begins at ages 9 to 11 and should be repeated every 5 years. Screening may be performed as early as age 2 if there is a family history of high blood cholesterol, heart attack, or stroke.
- Age 20 or older. Younger adults should be screened every 5 years. Men ages 45 to 65 and women ages 55 to 65 should be screened every 1 to 2 years.
If your blood cholesterol levels are not within the healthy range for your age and sex, your doctor may also recommend heart-healthy lifestyle changes to help you lower or control your high blood cholesterol and order a repeat lipid profile test.
Did you know that cholesterol is an important part of many organs in our body and that high levels of bad types of cholesterol can increase your risk of cardiovascular disease?
Cholesterol is an important building block for our bodies. Cholesterol is produced by many organs in the body with major contributions from the liver and the brain. The body also gets some cholesterol from the diet, but this has a minor effect on blood cholesterol levels. Cholesterol is a major component of all cell membranes and is used to make essential molecules such as hormones, fat-soluble vitamins, and bile acids to help you digest your food.
You may also see a measurement for triglycerides on your lipid panel. Like cholesterol, triglycerides are a type of blood fat. Triglycerides form when you eat more calories than you need. They can supply energy to your muscles. When triglyceride levels are too high, they can put you at risk of a heart attack or stroke.
Heart-healthy lifestyle changes to prevent high blood cholesterol
To prevent high blood cholesterol or if you have certain risk factors, your doctor may recommend that you adopt heart-healthy lifestyle changes, including eating healthy, being physically active, aiming for a healthy weight, quitting smoking, and managing stress.
Look for
- Diagnosis will explain how doctors use lipid panel tests to diagnose high blood cholesterol.
- Living With will discuss some additional medical care or lifestyle changes that your doctor may recommend to prevent your condition from recurring, getting worse, or causing serious complications such as heart attack or stroke.
- Research for Your Health will explain how we are using current research and advancing research to prevent high blood cholesterol.
- Participate in NHLBI Clinical Trials will explain our ongoing clinical studies that are investigating treatments for high blood cholesterol.
Signs, Symptoms, and Complications
High blood cholesterol does not cause specific symptoms. But people who have very high blood cholesterol may show signs such as xanthomas and corneal arcus. Undiagnosed or untreated high blood cholesterol can lead to serious complications such as heart attack and stroke.
Complications
High blood cholesterol levels lead to atherosclerosis, or the buildup of plaque deposits in blood vessels throughout the body. Over time, chronic or uncontrolled high blood cholesterol can cause serious complications including the following:
- Carotid artery disease
- Coronary heart disease, including angina or heart attack
- Peripheral artery disease
- Stroke
Do you know why high blood cholesterol can cause these complications?
Cells are not able to destroy cholesterol, so they transfer excess cholesterol to the high-density lipoprotein (HDL) to transport it back to the liver for elimination. In this way, HDL protects your heart from atherosclerotic disease, so HDL cholesterol is sometimes called good cholesterol. Low-density lipoprotein (LDL) is a lipoprotein that carries 75 percent of the cholesterol in blood to the peripheral tissues. LDL is removed from the blood by the liver to be eliminated or reused. When the amount of LDL is too high, the liver is not able to remove all of it. It is deposited in the blood vessels, contributing to the development of atherosclerosis, so sometimes LDL cholesterol is called bad cholesterol.
Look for
- Diagnosis will explain tests and procedures used to detect signs of high cholesterol and help rule out other conditions that may be causing high blood cholesterol.
- Treatment will discuss heart-healthy lifestyle changes or medicines that can help lower or control high blood cholesterol and help reduce the risk of complications.
- Living With will discuss some additional medical care or lifestyle changes that your doctor may recommend to prevent your condition from recurring, getting worse, or causing serious complications such as heart attack or stroke.
Diagnosis
Your doctor may diagnose you with high blood cholesterol based on your medical and family history, your physical exam, or whether you have consistently high low-density lipoprotein (LDL) cholesterol levels on repeat lipid panel blood tests. Your doctor may do more tests to see if other medical conditions may be causing high blood cholesterol.
Confirming unhealthy blood cholesterol levels
Doctors use lipid panel tests to diagnose high blood cholesterol. A lipid panel will measure the total cholesterol, good high-density lipoprotein (HDL) cholesterol, and non-high-density lipoproteins (non-HDL) cholesterol levels in your blood. Non-HDL cholesterol includes LDL cholesterol and is calculated by subtracting your HDL cholesterol levels from your total cholesterol levels.
Your doctor may diagnose you with high blood cholesterol if your total or non-HDL level, which includes LDL cholesterol, is higher than what is considered to be healthy for your age, sex, and health status.
![Healthy blood cholesterol levels differ by age or sex. If you are age 19 or younger, your total cholesterol levels should be less than 170 milligrams per deciliter (mg/dL) of blood, your non-HDL cholesterol level should be less than 120 mg/dL, your LDL cholesterol level should be less than 100 mg/dL, and your HDL cholesterol level should be more than 45 mg/dL. If you are age 20 or older, your total cholesterol should be between 125 and 200 mg/dL, your non-HDL cholesterol level should be less than 130 mg/dL, your LDL cholesterol level should be less than 100 mg/dL, and your HDL cholesterol level should be 40 mg/dL or higher if you are a man or 50 mg/dl or higher if you are a woman.](/congress115th/20190108215144im_/https://www.nhlbi.nih.gov/sites/default/files/inline-images/17-1432_NHLBI_HT_Q1_HBP_Table1_1200px_dev5_0.jpg)
Medical history
Your doctor will ask about your eating and physical activity habits, family history, and other risk factors for high blood cholesterol, heart attack, or stroke. Your doctor may ask whether you have any other signs or symptoms. This information can help your doctor determine whether you have complications or other conditions that may be causing you to have high blood cholesterol.
Physical exam
During your physical exam, your doctor will check for signs of very high blood cholesterol, such as xanthomas, or signs of other diseases that can cause high blood cholesterol.
Tests for other medical conditions
Your doctor may order some of the following tests for other medical conditions that may be causing your high blood cholesterol:
- Blood tests to check your thyroid hormone levels can help rule out hypothyroidism as a cause of high blood levels of cholesterol or other fats, such as triglycerides. Total testosterone and dehydroepiandrosterone sulphate tests can help rule out polycystic ovary syndrome (PCOS).
- Pelvic ultrasound to examine the ovaries and detect cysts. This can help rule out PCOS, which can affect cholesterol levels.
- Skin biopsy to help rule out inflammatory diseases, such as psoriasis, which can affect cholesterol levels.
Reminders
- Return to Risk Factors to review family history, lifestyle habits, or other environmental factors that increase your risk of developing high blood cholesterol.
- Return to Screening and Prevention to learn more about lipid panel tests.
Treatment
High blood cholesterol is treated with heart-healthy lifestyle changes and medicines to control or lower your high blood cholesterol. Lipoprotein apheresis is a procedure that can be used to treat familial hypercholesterolemia.
Heart-healthy lifestyle changes
To help you lower or control your high blood cholesterol, your doctor may recommend that you adopt the following lifelong heart-healthy lifestyle changes:
- Heart-healthy eating. As recommended in the 2015–2020 Dietary Guidelines for Americans, heart-healthy eating includes limiting the amount of saturated and trans fats that you eat. It also includes consuming fish high in omega-3 fatty acids and vegetable oils that can help lower blood cholesterol levels and the risk of cardiovascular disease. The Therapeutic Lifestyle Changes diet and the DASH Eating Plan can help you lower your bad low-density lipoprotein (LDL) cholesterol. These plans also encourage eating whole grains, fruits, and vegetables rather than refined carbohydrates such as sugar. Talk to your doctor about other nutritional changes that you can make.
- Being physically active. There are many health benefits to being physically active and getting the recommended amount of physical activity each week. Studies have shown that physical activity can lower LDL cholesterol and triglycerides and increase good high-density lipoprotein (HDL) cholesterol. Before starting any exercise program, ask your doctor what level of physical activity is right for you.
- Aiming for a healthy weight. If you have high blood cholesterol and are overweight or obese, you can improve your health by aiming for a healthy weight. Research has shown that adults with overweight and obesity can reduce LDL cholesterol and increase HDL cholesterol by losing only 3 percent to 5 percent of their weight. Achieving 5 percent to 10 percent weight loss in 6 months is recommended.
- Managing stress. Research has shown that chronic stress can sometimes increase LDL cholesterol levels and decrease HDL cholesterol levels.
- Quitting smoking. Visit Smoking and Your Heart and the National Heart, Lung, and Blood Institute's Your Guide to a Healthy Heart [PDF – 2.19 MB]. Although these resources focus on heart health, they include basic information about how to quit smoking. For free help and support to quit smoking, you may call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).
Medicines
If you are unable to lower or control your high blood cholesterol levels with lifestyle changes alone, your doctor may prescribe a medicine.
- Statins inhibit cholesterol synthesis in the liver by blocking the protein HMG-CoA reductase from making cholesterol. Liver cells try to compensate for the low cholesterol by synthesizing more LDL receptors on the cell surface to increase LDL uptake from blood. Statins are the most common medicine used to treat high blood cholesterol in people who are 10 years old or older. In certain cases, doctors may prescribe statins in people younger than 10 years old. Visit the Food and Drug Administration (FDA) Controlling Cholesterol with Statins for more information about statins.
- PCSK9 inhibitors lower LDL cholesterol by decreasing the destruction of LDL receptor in the liver, which helps remove and clear LDL cholesterol from the blood.
- Bile acid sequestrants block the reabsorption of bile acids and increase conversion of cholesterol to bile acids. This has the effect of lowering plasma cholesterol levels.
- Ezetimibe blocks dietary cholesterol from being absorbed in the intestine.
- Fibrates promote removal of very low-density lipoprotein (VLDL) cholesterol, part of non-HDL.
- Lomitapide blocks the liver from releasing VLDL cholesterol into the blood. It is used only in patients who have familial hypercholesterolemia.
- Mipomersen decreases levels of non-HDL cholesterol in the blood. It is used only in patients who have familial hypercholesterolemia.
- Niacin (nicotinic acid) decreases bad LDL cholesterol and triglycerides and raises HDL cholesterol.
If your doctor prescribes medicines as part of your treatment plan, be sure to continue your healthy lifestyle changes. The combination of the medicines and the heart-healthy lifestyle changes helps to lower and control your high blood cholesterol. Talk to your doctor about possible side effects to help decide which medicine is best for you.
Lipoprotein apheresis
Some patients with familial hypercholesterolemia may benefit from lipoprotein apheresis to lower their blood cholesterol levels. Lipoprotein apheresis is a dialysis-like process in which LDL cholesterol is removed from the blood by a filtering machine, with the remainder of the blood being returned to the patient.
Look for
- Research for Your Health will explain how the NHLBI is using current and advancing new research to treat people with high blood cholesterol.
- Living With will discuss some additional medical care or lifestyle changes that your doctor may recommend to prevent your condition from recurring, getting worse, or causing serious complications such as heart attack or stroke.
- Participate in NHLBI Clinical Trials will discuss our ongoing clinical studies that are investigating treatments for high blood cholesterol.
Living With
If you have been diagnosed with high blood cholesterol, it is important that you continue your treatment. Follow-up care can vary depending on your cholesterol levels, your risk of having a cardiovascular complication such as a heart attack or a stroke, and your response to treatment.
Monitor your response to treatment
Follow up with your doctor periodically to see how well your treatment is working, whether you need to add or change medicines, and whether your health condition has changed.
- Heart-healthy lifestyle changes. Initially, your doctor will recommend that you adopt lifelong lifestyle changes, including heart-healthy eating, being physically active, quitting smoking, managing stress, and managing your weight. Your doctor may refer you to a registered dietitian and an exercise physiologist.
- Medicines. If heart-healthy lifestyle changes alone are not enough, your doctor may prescribe a statin or other medicine to help lower or control your high blood cholesterol levels.
- Additional blood tests to screen for side effects of medicines or changes in health. Your doctor may order creatine kinase blood tests if you experience symptoms such as muscle fatigue, aching, tenderness, or stiffness while taking a statin. Liver enzyme tests can help determine whether a statin or other medicine is affecting your liver. Blood glucose tests can determine whether you have diabetes.
Monitor your risk of heart attack or stroke
High blood cholesterol increases your risk of cardiovascular complications such as a heart attack or stroke. Your doctor may periodically evaluate your risk for these complications by using a calculator such as the Atherosclerotic Cardiovascular Disease Estimator. This calculator estimates your risk of having a heart attack or stroke in the next 10 years. It considers your total and good high-density lipoprotein (HDL) cholesterol levels, age, and systolic blood pressure. It also factors in whether you have diabetes, smoke, or use medicines to control high blood pressure.
Your doctor will consider how unhealthy your blood cholesterol levels are and your 10-year risk calculation when deciding how best to treat your high blood cholesterol and to manage your risk of cardiovascular complications. Your doctor may recommend aspirin to prevent a first heart attack or stroke.
Keep in mind that this 10-year cardiovascular risk calculator may not accurately estimate risk in certain situations, such as when you are taking a statin; or in certain populations, such as Asians, Hispanics, or Native Americans.
Learn the warning signs of serious complications and have a plan
High blood cholesterol can lead to serious cardiovascular complications such as heart attack or stroke. If you think that you are or someone else is having the following symptoms, call 9-1-1 immediately. Every minute matters.
Heart attack
Signs of heart attack include mild or severe chest pain or discomfort in the center of the chest or upper abdomen that lasts for more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, heartburn, or indigestion. There may also be pain down the left arm.
Women may also have chest pain and pain down the left arm, but they are more likely to have less typical symptoms such as shortness of breath, nausea, vomiting, unusual tiredness (sometimes for days), and pain in the back, shoulders, or jaw. Read more about the signs and symptoms of a heart attack.
Stroke
If you think someone may be having a stroke, act F.A.S.T. and do the following simple test:
F—Face: Ask the person to smile. Does one side of the face droop?
A—Arms: Ask the person to raise both arms. Does one arm drift downward?
S—Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
T—Time: If you observe any of these signs, call for help immediately. Early treatment is essential.
Read more about the signs and symptoms of a stroke.
Reminders
- Return to Signs, Symptoms, and Complications to review other possible complications of high blood cholesterol.
- Return to Treatment to review all possible treatments for high blood cholesterol.
The NHLBI is part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH)—the Nation’s biomedical research agency that makes important scientific discoveries to improve health and save lives. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including high blood cholesterol. Learn about the current and future NHLBI efforts to improve health through research and scientific discovery.
Improving health with current research
Learn about the following ways in which the NHLBI continues to translate current research and science into improved health for people with high blood cholesterol:
- NHLBI Systematic Evidence Reviews Support Development of Guidelines for Blood Cholesterol in Adults. We continue to perform systematic reviews of the latest science. These reviews help partner organizations update their clinical guidelines, which health professionals use to treat adults who have high blood cholesterol. Visit Managing Blood Cholesterol in Adults Systematic Evidence Review From the Cholesterol Expert Panel, 2013 for more information.
- NIH Task Force to Develop First Nutrition Strategic Plan. We will collaborate with other institutes to develop a 10-year plan to increase research in nutrition, including experimental design and training. Visit NIH task force formed to develop first nutrition strategic plan for more information.
- Federal Dietary Guidelines for Americans. We continue to provide medical, nutritional, and other scientific expertise to the United States Department of Agriculture and HHS that publish the 2015–2020 Dietary Guidelines for Americans with information about the latest science-based nutritional recommendations.
- Global Leadership in Cardiovascular Health. We are proud to serve as a global leader and respond to legislative calls to increase U.S. global health efforts. The Health Inequities and Global Health Branch seeks to stimulate global health research, education, and training for many conditions, including high blood cholesterol.
Learn about some of the landmark NHLBI-funded studies that we have made over the years that have improved clinical care.
- Discovery of cholesterol as risk factor for cardiovascular disease. The Framingham Heart Study began in 1948 and helped discover that bad low-density lipoprotein (LDL) and good high-density lipoprotein (HDL) cholesterol levels can help predict the risk of cardiovascular diseases such as heart attack and stroke. Visit the Framingham Heart Study for more information.
- Conducting research that helped discover statins. The Lipid Research Clinics Coronary Prevention Trial was done from 1973 to 1989 and provided data to see whether lowering LDL cholesterol and total cholesterol could decrease rates of heart disease and mortality. This stimulated new research that helped discover statins as a treatment to decrease LDL cholesterol levels in the blood. Visit Lipid Research Clinics Coronary Primary Prevention Trial for more information.
- Investigating the history of damage to the heart and blood vessels in children and young adults. The Bogalusa Heart Study was done from 1973 to 1996. One of the findings was that PCSK9 variants are associated with significantly lower LDL cholesterol levels. This discovery helped catalyze new research into PCSK9 that led to Food and Drug Administration (FDA)-approved treatments for high blood cholesterol that inhibit PCSK9. Visit Bogalusa Heart Study for more information.
- Studying how plaque forms in the blood vessels. The Atherosclerosis Risk in Communities Study (ARIC) study was done from 1987 to 2016 to assess the progression and causes of plaque buildup and how cholesterol and other factors increase the risk for plaque buildup. ARIC also examined how risk factors, medical care, and disease vary based on location, time, and race and gender of the patient. Visit the Atherosclerosis Risk in Communities Study for more information.
- DASH eating plan to lower high blood pressure and cholesterol. The NHLBI funded the DASH trial from 1993 to 1997. The study showed the health benefits of the DASH eating plan in lowering high blood pressure and LDL cholesterol. It found that while the DASH plan also decreases HDL cholesterol, it helps overall in preventing heart disease. Visit the DASH Eating Plan for more information.
- Comparing effects of statin and diet treatment with diet alone. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) study began in 1994 and lasted eight years. Its purpose was to compare the effects of a cholesterol-lowering statin medicine and diet with the effects of diet alone to prevent cardiovascular diseases. At the end of the study, both groups had significantly lower cholesterol, probably because many participants in the usual care group received a cholesterol-lowering drug. Visit the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial for more information.
- Studying HDL cholesterol. The NHLBI Proteomics Initiative began in 2002 and ended in 2009. It involved a consortium of 10 research centers that developed innovative technologies in proteomics—the study of large groups of proteins in cells, tissues, and organs. One of the proteins studied was HDL; researchers looked at its various functions, such as its ability to carry cholesterol to the liver and prevent modifications of LDL that are related to plaque formation.
- Improving HDL cholesterol benefits of the DASH diet. The OmniHeart Study, funded by the NHLBI from 2003 to 2005, was an effort to improve the DASH diet by maintaining its LDL cholesterol-lowering effect while increasing in HDL, or good, cholesterol. Researchers replaced carbohydrates with either protein or monounsaturated fats and found that protein had a better effect on the lipid profiles of study subjects by lowering LDL cholesterol and triglycerides. Monounsaturated fats lowered triglycerides and increased HDL cholesterol, but had no effect on LDL cholesterol.
- Assessing heart disease risk in young adults. The Coronary Artery Risk Development in Young Adults (CARDIA) Study began in 1983 to help understand the development and risk factors for diseases of the heart and the blood vessels. Among other discoveries, it found that in young adults, the levels of apolipoprotein B, a particle associated with bad cholesterol, can predict who will develop calcium deposits in heart vessels that are associated with higher risk for heart attack. Visit the Coronary Artery Risk Development in Young Adults Study for more information.
- Informing treatment for high blood cholesterol. The AIM-HIGH Study helped to inform best clinical care practices for high blood cholesterol when it discovered that adding niacin to statin was not more effective in preventing heart attacks and strokes than statin alone. The study ended early and led the FDA to no longer approve the use of niacin with statins to prevent heart attack or stroke.
Advancing research for improved health
In support of our mission, we are committed to advancing high blood cholesterol research in part through the following ways:
- We perform research. Our Division of Intramural Research, which includes investigators in our Lipoprotein Metabolism Laboratory, is actively engaged in the study of the anti-inflammatory properties of HDL cholesterol in the prevention of atherosclerosis.
- We fund research. The NHLBI plans to continue its tradition of conducting large, long-term population studies to examine high blood cholesterol as a risk factor for heart disease. Studies include the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and the Strong Heart Study, which will provide cholesterol data in minority populations. Through the NHLBI HIV/AIDS Program, our Division of Cardiovascular Sciences funds research to help understand statin benefits in people with HIV who have an increased risk for heart disease. The research that we fund today will help improve our future health. Search the NIH RePORTer to learn about research that the NHLBI is funding on high blood cholesterol.
- We stimulate high-impact research. Our Trans-Omics for Precision Medicine (TOPMed) program now includes participants with high blood cholesterol, which may help us understand how genes contribute to differences in disease severity and how patients respond to treatment. The NHLBI Strategic Vision highlights ways in which we may support research over the next decade, including new efforts to understand high blood cholesterol.
Learn about exciting research areas NHLBI is exploring that involve high blood cholesterol.
- Cholesterol vaccine. The PCSK9 protein prevents the liver from removing LDL cholesterol from the blood. The NHLBI is funding research to develop a vaccine that may reduce the PCSK9 protein, thereby decreasing blood cholesterol levels in blood.
- Discovering the role of other proteins involved in cholesterol transport. The NHLBI is funding this study to understand how the apoA-I protein, found in HDL cholesterol, helps transport cholesterol from the cells to the liver, where it is removed from the blood.
- Effects of red meat and other sources of protein on blood cholesterol levels. The NHLBI and other research partners are investigating whether higher levels of LDL cholesterol occur after eating saturated fat from red meat versus other sources of protein, such as white meat.
- Genetics and high blood cholesterol. The NHLBI is funding multiple studies to help understand how genes affect the levels of cholesterol in blood. These studies include genetic variability in non-coding RNA elements called microRNAs, the study of patients with known genetic diseases affecting lipids, and the study of genetic markers that can help understand why some patients respond better than others to pharmacological therapy and different eating patterns.
Look for
Participate in NHLBI Clinical Trials will discuss our ongoing clinical studies that are investigating treatments for high blood cholesterol.
We lead or sponsor many studies on high blood cholesterol. See if you or someone you know is eligible to participate in our clinical trials.
Do you or does your child have a lipid disorder and want to improve future diagnosis and treatment?
Are you a healthy adult with no history of heart problems?
Are you 40 or older and being treated for HIV?
Are you an adult who wants to prevent high blood cholesterol?
Are you an adult who is interested in helping research on lipid disorders?
Do you or your child have a lipid disorder and want to help research?
Learn more about participating in a clinical trial.
View all trials from ClinicalTrials.gov.
After reading our High Blood Cholesterol Health Topic, you may be interested in additional information found in the following resources.
Related Health Topics
Other Resources
NHLBI resources
- Aim for a Healthy Weight
- Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report
- Your Guide to Lowering Your Cholesterol With Therapeutic Lifestyle Changes (TLC)
Non-NHLBI resources
- 2008 Physical Activity Guidelines for Americans (U.S. Department of Health and Human Services (HHS))
- Dietary Guidelines for Americans 2015–2020 Edition (HHS and U.S. Department of Agriculture)
- Cholesterol (National Library of Medicine, [NLM] MedlinePlus)
- Cholesterol Good and Bad Video (NLM, MedlinePlus)
- Controlling Cholesterol with Statins (Food and Drug Administration)
![stethoscope on EKG graph](/congress115th/20190108215144im_/https://www.nhlbi.nih.gov/sites/default/files/styles/16x9_crop/public/2017-11/shutterstock_515490628.jpg?itok=x8a8MUCC&h=1b99f2bb)
Bethesda, MD
In September 2014, the NHLBI convened a group of experts in the areas of cardiovascular risk assessment, treatment ...