High LDL cholesterol: what it means and how to lower it

High LDL cholesterol causes no symptoms, but if it stays high for years it builds up in your arteries. Your family’s genes and your diet are usually behind it, sometimes weight and too little movement. It often comes down when you change what you eat and how you move. If that is not enough, your doctor will consider medicines.

What high LDL cholesterol means

It means there is more LDL cholesterol in your blood than would be good for you. It does no harm right away: what matters is how high it is and for how many years it stays that way.

The longer it stays high, the more cholesterol builds up in the walls of your arteries. Bringing it down lowers the risk, and the sooner you do it, the more it counts.

A high number is not a diagnosis: your doctor reads it with everything else, from blood pressure to family history.

What causes high LDL cholesterol

The first two are the most common.

Symptoms

Usually none. You cannot feel high LDL: a blood test is how you find out.

In the inherited form, after years of very high levels, small lumps can appear on tendons, for example at the heel or over the knuckles. If you notice them, tell your doctor, and the same goes for small yellowish patches on the eyelids.

Familial hypercholesterolaemia, in plain words

It is an inherited form of high cholesterol. You are born with genes that make it harder for your liver to clear LDL from your blood, so the number is high from childhood.

It is not rare, but it often goes unnoticed. An LDL of 190 or more can raise the suspicion, especially if people in your family had heart attacks at a young age.

Your doctor usually suggests testing your family too: parents, brothers, sisters and children can have it. Treatment generally includes medicines, and the sooner it starts, the more it protects.

Which tests to read alongside it

These tests help show your risk and the cause.

What your result means

The upper end of the scale, in mg/dL.

How to lower LDL cholesterol

It starts with what you eat. Where to begin:

When to worry

Talk to a doctor if:

With Rosa, an LDL of 190 or more is always flagged to a doctor; above 400, urgently.

Frequently asked questions

LDL cholesterol at 150 or 160: is it serious? It is not an emergency, but it is high: above the limit on lab reports. Change what you eat and repeat the test after about three months. Your doctor weighs your risk and whether you need medicines.

How can I lower LDL cholesterol without medicines? With food and movement: less saturated fat, more olive oil, nuts, oats, barley and legumes, and a few kilos less if needed. For a number just above the limit, that can be enough. If it is very high, or your risk is high, your doctor may suggest medicines; if you already take them, do not stop on your own.

How long does it take to bring it down? With changes to what you eat, the effect usually shows in about three months: that is the time to repeat the test. After that, what counts is keeping it low over the years.

Which foods should I avoid with high LDL cholesterol? Swapping matters more than cutting out: less butter, lard, fatty cheese, fatty or processed meat and foods made with palm oil. In their place, extra virgin olive oil, nuts, fish and legumes.

Does omega-3 lower LDL cholesterol? No. Omega-3 lowers triglycerides, not LDL, and kinds rich in DHA can raise it a little. If you see it rise after starting them, that is an expected effect.

Sources