How is LDL related to high cholesterol?

Douglas S. Denham, DO
Family Medicine

High cholesterol (hypercholesterolemia) is a condition that affects 1 in 6 Americans. Cholesterol is a part of the fats (lipids) that are in the foods we eat. Cholesterol is important for the production of hormones, cell walls and steroids that our body needs to survive. The problem arises when we eat or make too much cholesterol. There are many types of cholesterol. High Density lipoprotein (HDL) is good cholesterol. It serves to pick up excess cholesterol in the blood vessels and takes it back to the liver. Low –density lipoprotein (LDL) is considered a bad form of cholesterol because it will become incorporated in the cells that make up the lining of the blood vessels and causes them to form the plaques that lead to narrowing of the blood vessels. These plaques are hard areas that can lead to clotting off the vessel and cause heart attack or stroke. Very-low-density lipoproteins (VLDL) also contains triglycerides, a type of fat, that can also become part of the cell lining the blood vessels and lead to narrowing and clots.

High cholesterol does not make you feel bad until it is too late. The only way to find out how high your cholesterol is to have a blood test. Based on these results, you and your doctor can decide on what treatment you will need.

The primary treatment is dietary change. Diets low in fat, especially saturated fats, are a key first step in the treatment of high cholesterol. Mediterranean diets, high is fish oil (omega 3) and olive oils which are unsaturated oils are the best types of fats to eat.

Exercise is also a way to fight high cholesterol. Exercise helps raise the HDL while lowering the LDL cholesterol. It also helps reduce weight and high blood pressure, both of which are risk factors for high cholesterol.

If you smoke: stop. Smoke contains chemicals which can damage blood vessels and lead to the accumulation of LDL in these cells. It also lowers your HDL cholesterol.

If you have diabetes, work harder to get your diabetes under control. Poorly controlled diabetes leads to higher LDL and lower HDL cholesterol. High blood sugars also contribute to damage to the cells lining the blood vessels.

If these measures do not lower your cholesterol sufficiently, there are numerous medications that your doctor can prescribe to treat high cholesterol. These medications work at the liver affecting the production and removal of cholesterol from the blood. 

LDL, or low-density lipoprotein, is often considered bad cholesterol and tends to raise your risk for high cholesterol. The higher your LDL, the greater your build-up of fatty substances in your bloodstream. LDL helps to transfer cholesterol to cells, but often tends to oversupply them. Once LDL delivers cholesterol, HDL removes the cholesterol and brings it to the liver. A healthy LDL blood level is less than 100 mg/dL, while an unhealthy LDL blood level is 160 mg/dL and above, assuming one does not have any other medical problems that may necessitate lower cholesterol goals.

Michael J. Bloch, MD
Internal Medicine
A regular cholesterol panel gives information about 3 different types of lipids:  HDL (or good cholesterol), triglycerides, and LDL (or bad) cholesterol. "High cholesterol" is really a non-specific term that I try to avoid using in my practice. High LDL cholesterol is a risk factor for heart disease and stroke, but so is high triglycerides or a low HDL cholesterol. It is important to look at all aspects of the cholesterol panel, not just the total cholesterol.

Continue Learning about High Cholesterol

My Story: Harv and High Cholesterol
My Story: Harv and High Cholesterol
"The best thing you an do is listen to your body," says Harv. In this video, he shares how he first recognized the symptoms of heart disease in himsel...
Read More
Who should take lomitapide?
Donna Hill Howes, RNDonna Hill Howes, RN
Current cholesterol management guidelines state that non-statin drugs are not first-line therapy. Bu...
More Answers
What is Praluent (alirocumab)?
Praluent is a cholesterol-lowering drug called a PCSK9 inhibitor. It was approved by the U.S. Food a...
More Answers
4 Tips to Stop Metabolic Syndrome in Its Tracks
4 Tips to Stop Metabolic Syndrome in Its Tracks

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.