What Is Cholesterol?

Cholesterol is a waxy-like material the body uses as a building block for cells and hormones. It's carried in the bloodstream.

When blood levels stay elevated, cholesterol may join with other substances to form a thick, hard deposit on the inside of the arteries called plaque.

Over time, buildup of these deposits may narrow arteries throughout the body, making them less flexible and decreasing the amount of oxygen-rich blood going to the heart, brain and legs. The result: An increased risk for heart attack, stroke and peripheral arterial disease.

Because high cholesterol levels rarely cause any noticeable symptoms, ensuring that cholesterol is regularly checked and knowing one’s numbers are essential for long-term heart and brain health.

The American Heart Association and the American College of Cardiology recommend regular cholesterol assessment as part of a broader strategy to prevent heart attack and stroke.

Where Does Cholesterol Come From?

There are two main sources of cholesterol. Your liver makes all the cholesterol your body requires for normal functioning. The amount of cholesterol your liver makes is in part genetically determined.

The other source of cholesterol comes from our diets, especially in foods that come largely from animals. Meat, poultry and dairy products all contain dietary cholesterol. Red meat, fried chicken, shrimp, lobster, cheese and butter are examples of animal foods with the highest amounts of dietary cholesterol.

Tip: Focus on lean sources of animal protein, including fish.

Saturated and trans fats also increase blood cholesterol, more than that of dietary cholesterol. These fats are in animal-based foods but also abundant in plant oils and processed foods. For example, tropical oils including palm oil and coconut oil are rich in saturated fat that increase cholesterol and, in turn, heart disease and stroke risk. These oils are commonly found in baked goods and ultra-processed foods, which may also contain unhealthy trans fats.

Tip: Avoid ultra-processed foods that are high in saturated fat, added sugars and sodium (such as baked goods and fried foods).

Tip: Increase dietary fiber. It helps lower cholesterol levels and improves cardiovascular health. Vegetables, fruits, whole grains, beans, nuts and seeds are all rich sources of dietary fiber.

The Bad Kind Of Cholesterol

Low-density lipoprotein-cholesterol (LDL-C) is known as the bad kind of cholesterol. High levels of LDL-C cause plaque buildup in the blood vessels, which may lead to heart disease and stroke.

Lower LDL-C levels are linked to better heart and brain health, and the right level for you depends on your baseline risk for heart attack and stroke.

Lower LDL-C levels are also associated with a much lower risk of plaque progression. Your primary care clinician and/or cardiologist may help determine the goal that’s right for you.

The Good Kind Of Cholesterol

High-density lipoprotein-cholesterol (HDL-C) is often referred to as the good kind of cholesterol. High levels of HDL-C are often associated with a lower risk of heart disease and stroke.

Triglycerides Contribute To High Cholesterol

Triglycerides are a type of fat in your body. A high level of triglycerides may contribute to cholesterol buildup in your body and increase heart disease and stroke risk. Similar to LDL-C, triglycerides may increase with consumption of foods high in saturated fats and added sugars.

Check Your Cholesterol To Lower Your Risk Of Heart Attack And Stroke

It’s important to regularly check your cholesterol to make sure you’re at a healthy level for you, personalized to your risk for heart disease and stroke.

What’s A Healthy Cholesterol Range?

Total cholesterol <200 mg/dL
LDL-C <100 mg/dL*
HDL-C >40 mg/dL (men), >50 mg/dL (women)
Non-HDL-C <130 mg/dL
Triglycerides <150 mg/dL when fasting, <175 mg/dL when not fasting

* The 2026 guideline from the American College of Cardiology and the American Heart Association says LDL-C goals should be personalized based on an individual's risk of heart attack and stroke:

For people without any plaque buildup and who are at low risk for heart attack and stroke, the LDL-C goal is below 100 mg/dL.
For people with mild-to-moderate plaque buildup or with diabetes, the goal LDL-C is less than 70 mg/dL.
For those with severe plaque buildup in the arteries or who have had a prior heart attack, stroke or a surgical procedure to open up or bypass a very narrowed artery, the goal LDL-C is less than 55 mg/dL.

How High Cholesterol Is Diagnosed

A simple blood test called a lipid panel measures your cholesterol. These results are not interpreted in isolation. They are assessed along with other risk factors for heart disease and stroke, such as high blood pressure, obesity, diabetes, cigarette smoking and others.

Symptoms — Why You Usually Can’t Feel It

High cholesterol usually causes no symptoms until the first manifestation of heart attack or stroke when there is a total blockage of an artery. As such, sustained high cholesterol contributes to plaque build up without any warning signs over many years.

This is why regularly checking your cholesterol levels and awareness matter for preventing heart disease and stroke. Checking your levels at least annually may help you protect your arteries and optimize cardiovascular health.

Cholesterol Causes And Risk Factors

Family history and inherited conditions, including familial hypercholesterolemia, or high LDL cholesterol
Eating patterns high in saturated fats and dietary cholesterol
Limited physical activity
Other health conditions that affect how your body handles cholesterol, such as diabetes, thyroid disorders, as well as diseases that affect the liver or kidneys
Medications, such as glucocorticoids or supplemental estrogen

A thorough evaluation of your medical history and lifestyle will help to determine the best management strategy.

How You Treat And Manage It

Healthy lifestyle habits are the foundation of cholesterol management and small changes may add up over time.

Dietary adjustments are the most influential lifestyle change to make. Regular physical activity, better sleep and avoiding tobacco may also improve your cholesterol profile and support heart health.

While lifestyle changes are foundational, they aren’t always enough. Cholesterol-lowering medications are safe and used in conjunction with lifestyle changes to help further lower cholesterol to healthy levels and reduce risk for heart disease and stroke.

Medications that lower LDL-C are especially helpful for those with genetically high cholesterol and inherited conditions, including familial hypercholesterolemia. These decisions are personal and are best made in consultation with your doctor.

Living With Elevated Cholesterol

Cholesterol management isn’t about perfection. It’s about understanding where you are today and reviewing management options with your doctor that fit your life and your health goals.

More information

The American Heart Association has more on cholesterol and how to keep it in check.

About the experts

Dr. Alexander Razavi is a cardiology fellow at Emory University School of Medicine in Atlanta. His clinical and research interests are in preventive cardiology, cardiovascular disease risk assessment, and cardiovascular computed tomography. Dr. Razavi has contributed to national scientific statements and serves on leadership committees for the American Heart Association and American Society of Preventive Cardiology.

Dr. Roger S. Blumenthal is the Kenneth Jay Pollin Professor of Cardiology and the director of the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease in Baltimore. He graduated with honors from Johns Hopkins and Cornell Medical College.

Dr. Blumenthal was the recipient of the Agatston Cardiovascular Disease Prevention Award for his work in selective use of cardiac CT to improve cardiovascular risk assessment. He also received the Joseph Stokes, III, MD Pioneer in Prevention Award from the American Society of Preventive Cardiology. In 2026, he was the recipient of the AHA’s Council on Clinical Cardiology Distinguished Achievement Award.

Dr. Blumenthal also served as co-chair of the 2019 ACC/AHA Primary Prevention of Cardiovascular Disease Guideline and co-chair of the 2026 ACC/AHA/Multisociety Dyslipidemia Clinical Practice Guideline.

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