A good way to detect High Blood cholesterol early, so that you can take steps to improve your health, is to have a regular blood test to measure your cholesterol level. Some doctors recommend having your levels of HDL cholesterol and of triglycerides measured initially, along with your total cholesterol level. A typical blood-screening test measures:

• Total cholesterol
• HDL cholesterol
• Triglycerides

Values for LDL cholesterol can be calculated from the other three values. You usually don’t need a precise measurement of your LDL cholesterol level, but when it is needed, another blood test can specifically determine your LDL level.

Measuring only total cholesterol can be misleading because some people have low levels of HDL cholesterol and high levels of triglycerides, but normal or even high levels of LDL cholesterol. In these cases, a total cholesterol measurement might appear normal. You and your doctor would be unaware of the risk of Heart disease posed by the abnormal levels that weren’t measured. Even with a desirable total cholesterol level, if you have a low HDL level, you may be at increased risk of Heart disease.

The results of blood tests for lipoprotein levels fall into optimal, near optimal, borderline high risk, high risk and very high risk categories. Desirable ranges for cholesterol levels vary depending on risk factors, such as your age, sex, family history and health condition. There’s no magic number that separates risky levels from safe levels. Instead, experts have identified levels of lipids in the blood above which the risk of developing coronary complications is high enough to warrant lifestyle changes. Talk to your doctor about what level is appropriate for you.

Have your baseline cholesterol tested when you’re in your 20s and then at least every five years. If your values aren’t within desirable ranges, your doctor may advise more frequent measurements.

You can also purchase a home cholesterol test. These tests measure only total cholesterol, are less sophisticated than laboratory tests and may give unreliable results.

Children generally don’t need to undergo cholesterol testing, unless there’s a family history of early-onset heart problems.

Complications

High Blood cholesterol can cause you to develop Heart disease. The American Heart Association reports that Heart disease kills over 1.4 million Americans each year, more than all cancer deaths combined. Many of these deaths occur because of the accumulation of fatty deposits (plaques) on the walls of your arteries (Atherosclerosis), resulting in narrowed or blocked arteries. Cholesterol plays a significant role in this largely preventable condition.

Atherosclerosis is initially a silent, painless condition that results in reduced blood flow. If reduced flow occurs in the arteries that supply your heart with blood (coronary arteries), it can lead to a type of chest pain called angina pectoris.

As a plaque enlarges, the inner lining of your artery becomes roughened. A tear or rupture in the plaque may cause a blood clot to form. Such a clot can block the flow of blood or break free and plug an artery downstream.

If the flow of blood to a part of your heart is stopped, you’ll have a heart attack. If blood flow to a part of your brain stops, a stroke occurs.

High Blood cholesterol along with High Blood Pressure, insulin resistance and obesity are factors that make up metabolic syndrome, a combination of disorders which greatly increases your risk of developing Heart disease, stroke or diabetes.

Treatment

Lifestyle changes are the first steps you can take to improve your blood levels of cholesterol and triglycerides. These include changes in diet, regular exercise and avoiding smoking. If you’ve made these important lifestyle changes and your total cholesterol � especially your level of LDL cholesterol � remains high, your doctor may recommend prescription medication.

Before recommending medication, your doctor may weigh many variables � your changeable risk factors, your age, your current health and the drug’s side effects. If you need a medication to improve your cholesterol levels, chances are you may need it for many years.

Your LDL cholesterol level is usually the deciding factor. If you have no other risk factors for Heart disease, an LDL level greater than 190 milligrams per deciliter (mg/dL) generally warrants medication. With two or more risk factors, an LDL level greater than 160 mg/dL may require medication. If plaques have narrowed the arteries to your heart and restricted the flow of oxygen-rich blood to your heart’s muscles (coronary artery disease), your doctor may suggest medication and lifestyle changes to lower your LDL to less than 100 mg/dL. And if you’re considered at very high risk, you and your doctor may even discuss lowering your LDL to less than 70 mg/DL.

Medications to improve blood cholesterol levels include:

• Resins. The medications cholestyramine (Questran) and colestipol (Colestid) lower cholesterol indirectly by binding to bile acids in your intestinal tract. Your liver makes bile acids, which you need for digestion, from cholesterol. By tying up bile acids, resins prompt your liver to make more bile acids. Because your liver uses cholesterol to make bile acids, less cholesterol is available to reach your bloodstream.
• Triglyceride-lowering drugs. These medications include fibrates such as gemfibrozil (Lopid) and fenofibrate (Tricor), and niacin (Nicotinic Acid). Fibrates reduce triglyceride production and remove triglycerides from circulation. They can also increase your HDL cholesterol level.
• Statins. Statins work directly in your liver to block a substance your liver needs to make cholesterol. This depletes cholesterol in your liver cells, which causes your liver cells to remove cholesterol from your blood. Statins may also help your body reabsorb cholesterol from plaques that accumulate on the walls of your arteries. This process may slowly open blocked blood vessels. Statins include fluvastatin (Lescol), lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), atorvastatin (Lipitor) and rosuvastatin (Crestor).
• Cholesterol absorption inhibitor. Your small intestine absorbs the cholesterol from your diet. After that, dietary cholesterol enters the bloodstream. Your total cholesterol is the result of dietary cholesterol and the cholesterol the liver produces itself. The drug ezetimibe (Zetia) helps reduce blood cholesterol by limiting the absorption of dietary cholesterol. Cholesterol absorption inhibitor-plus-statin combination. The combination drug ezetimibe/simvastatin (Vytorin) decreases both absorption of dietary cholesterol in your small intestine and production of cholesterol in your liver.

Prevention

Improving your blood cholesterol levels reduces your risk of Heart disease. Lifestyle changes are your first course of action to improve your blood cholesterol levels. These approaches include eating a healthy diet, exercising and not smoking.

Eating a healthy diet
These changes in your diet can improve your blood cholesterol levels:

• Control total fat. Limit all types of fat � saturated, polyunsaturated, trans fatty acids (trans fats) and monounsaturated � to no more than 30 percent of your total daily calories. Because all foods with fats contain a combination of these fats, it’s important to reduce total fat. Not every food you eat must have less than 30 percent of its calories from fat. Use the guideline as a daily average. By balancing occasional high-fat foods with low-fat choices, your fat intake should average no more than 30 percent of your daily calories. If your daily intake is 2,000 calories, 30 percent equals 65 grams of fat. Limit saturated fat to no more than 10 percent of total calories.
• Limit dietary cholesterol. Your daily limit for dietary cholesterol is 300 milligrams, or less than 200 milligrams if you have Heart disease. To accomplish this goal, limit or avoid concentrated sources such as organ meats, egg yolks and whole-milk products.
• Eat foods with soluble fiber. As part of a low-fat diet, soluble fiber can help lower your total blood cholesterol level. Foods high in soluble fiber include oat bran, oatmeal, beans, peas, rice bran, barley, citrus fruits, strawberries and apple pulp.
• Eat more fish. Some fish � particularly fatty types prevalent in cold water, such as salmon, mackerel and herring � contain high amounts of a unique type of polyunsaturated fat called omega-3 fatty acids. Omega-3s may lower your level of triglycerides. However, pregnant women, women who are breast-feeding and women who plan to become pregnant in the next several years, and young children should not eat king mackerel, shark, swordfish or tilefish. They should also limit their weekly intake of albacore tuna and locally caught fish, according to the Food and Drug Administration. Salmon, canned light tuna, pollock, shrimp and catfish are generally low in mercury.
• Consider soy products. Soy compounds called isoflavones act like human hormones that regulate cholesterol levels. Eating soy proteins can reduce your levels of total cholesterol, LDL cholesterol and triglycerides. Eating soy may also raise your level of HDL cholesterol, which may protect you against Heart disease.
• Drink alcohol in moderation, if at all. Moderate consumption of alcohol may raise your level of HDL cholesterol. The best advice is to drink in moderation, if you drink at all. Limit alcohol to one drink daily if you’re a woman or to no more than two drinks daily if you’re a man. If you’re a nondrinker, don’t start drinking alcohol. Don’t drink alcohol if you have a high level of triglycerides.
• Reduce sugar intake. This is a way of lowering triglyceride levels. Ideally, your triglyceride levels should be lower than 150 mg/dL.

Exercising
Being overweight promotes a high total cholesterol level. Losing weight improves your cholesterol levels. Set up an exercise program to lose weight using these guidelines and your doctor’s advice:

• Choose an aerobic activity. Get involved in activities such as brisk walking, jogging, bicycling or cross-country skiing.
• Build up the time and frequency of exercising. Gradually work up to exercising for 30 minutes to 45 minutes at least three times a week. If you’re overweight or have been inactive for many years, take several months to work up gradually to this level. The higher the level of your activity, the greater your rate of weight loss.
• Stick with your exercise program. Schedule a regular time for exercise. Make exercise fun. If it’s not enjoyable, you may not feel like exercising regularly year in, year out. Find a friend or join an exercise group to keep you motivated and committed to exercise. Or take up an activity that keeps you active.

Not smoking
If you smoke, stop. If you don’t smoke, don’t start. Cigarette smoking damages the walls of your blood vessels, making them prone to accumulating fatty deposits. If you stop smoking, your HDL cholesterol may return to its former level.