Cholesterol explained: What the numbers mean

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Doctors often refer to heart disease as "the invisible killer." That's because the risk factors — like high blood pressure or high cholesterol — for heart disease often don't show any obvious symptoms until it's too late. Getting your cholesterol checked regularly (every four to six years if you don't have a personal or family history of high cholesterol or more frequently if you do) is an important part of staying in control of your health.

To check your cholesterol, your doctor will likely order a lipid panel through a simple blood draw as part of your annual preventive exam. This test reveals four numbers: total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides. Now that you have these numbers, you might be wondering: what do they mean? How do they affect my health? How can I make sure my numbers are in the healthy range?

Here are our answers to your most burning questions about cholesterol.

First of all — what is cholesterol?

Cholesterol is a type of fat found in the blood. Though necessary for making a lot of chemical substances in the body, a high level of cholesterol, especially the LDL type, increases the risk of heart disease and stroke. LDL cholesterol comes from two sources — the foods you eat and through production in your liver. Another type of cholesterol, the HDL type, is actually beneficial and high levels actually decrease your risk of heart disease and stroke.

What causes high cholesterol?

Among other factors, diet and exercise can impact your cholesterol levels. Exercising regularly — getting 150 minutes a week of moderately intense activity — will help you maintain an ideal weight and achieve a good balance of good and bad cholesterol. Being at a healthy weight also helps with your triglycerides and blood sugar, which further reduces your risk of heart disease.

When it comes to eating, the fresher the food the better. Greasy, fried food often tastes good, but from a nutritional standpoint is not healthy for your heart. Aim to eat things you can prepare yourself instead of grabbing food at a drive-through window. Try to stay away from empty calories like fruit juices, colas and sugary espresso drinks.

What will happen if you have high cholesterol?

High cholesterol, like high blood pressure, high blood sugar and a high body mass index (BMI), is a risk factor for heart disease. If you have LDL higher than 100 mg/dL, HDL lower than 50 mg/dL and/or total cholesterol higher than 200 mg/dL, your cholesterol levels are high. This increases your risk for the build-up of plaque in your arteries, which can lead to a heart attack or stroke.

Triglycerides, the other number you'll see on your lipid panel, are another fatty substance in your blood. If your body can’t process glucose or sugar effectively, this level will go up. If your triglycerides are higher than 150 mg/dL, it can be hard on your pancreas and potentially lead to prediabetes.

If I eat something with a lot of cholesterol, will that make my numbers go up?

Not necessarily. When you're reading nutritional labels, you don't want to pay attention to the amount of cholesterol as much as the type of fat. When consuming fat, you want to get unsaturated fats like polyunsaturated and monounsaturated fat — which is found in avocados, olives, peanut butter, fatty fish like salmon and mackerel, nuts and seeds.

Fats you want to avoid in high amounts are saturated fat, which are often found in animal products like meat and dairy, and trans-fat, often found in processed foods like cookies, cakes, crackers, margarine and microwavable popcorn.

How do I lower my cholesterol?

Sometimes, high cholesterol can be lowered naturally. Eating a fiber-rich diet that is lower in fat can increase your HDL cholesterol and lower your LDL cholesterol. However, some people follow the proper diet and exercise but still have high cholesterol — and high LDL in particular. One of the reasons for this is you can inherit high cholesterol levels. So, if one or more of your family members has high cholesterol, your risk for having it increases as well.

If you have consistently high cholesterol levels, your doctor will likely recommend medication. Generally, you'll be prescribed a statin, a type of medication that works in the liver to lower LDL cholesterol. No matter what you hear, high cholesterol is not something that can be cured. However, it's manageable with a healthy lifestyle and medication.

It’s important to keep up with your preventive care, as routine blood work will allow you and your doctor to keep an eye on your cholesterol. Your primary care provider can also offer advice on how to better manage your cholesterol and connect you to a specialist if needed.

Maintaining healthy cholesterol levels is just one of the things you should do to keep your heart healthy. For more information on how to make sure your heart is in tip-top shape, check out our other heart-health articles:

• Test your heart-health IQ: Answer five quick questions to see how much you know about your heart.
• His risk, her risk: Read this story from a Wellmark member and learn how to spot the symptoms of a heart attack.
• Controlling high blood pressure: Are you or your provider more in charge of controlling your high blood pressure? Let's find out.
• Get the most accurate at-home blood pressure reading: Get tips for taking your blood pressure at home.