Know Your Risk for High Cholesterol

Certain health conditions, your lifestyle, and your family history can raise your risk for high cholesterol. These are called “risk factors.”

High cholesterol can run in families. If you have a family history of high cholesterol, you are more likely to have high cholesterol.

You can’t control some of these risk factors, such as your age or your family history. But you can take steps to lower your risk for high cholesterol by changing things you can control.

What health conditions increase my risk for high cholesterol?

Certain health conditions increase your risk for high cholesterol:

• Type 2 diabetes lowers high-density lipoprotein (HDL, or “good”) cholesterol levels and raises low-density lipoprotein (LDL, or “bad”) cholesterol levels. This combination raises your risk of heart disease and stroke. Learn more about type 2 diabetes.
• Obesity is linked to higher triglyceride levels, higher LDL cholesterol levels, and lower HDL cholesterol levels. Obesity can also lead to heart disease, high blood pressure, and diabetes. Talk with your health care team about a plan to reduce your weight to a healthy level. Learn more about overweight and obesity.
• Other health conditions, such as familial hypercholesterolemia, can cause very high LDL cholesterol levels.

What is familial hypercholesterolemia (FH)?

Some people have an inherited genetic condition called FH. This condition causes very high low-density lipoprotein (LDL, or “bad”) cholesterol levels beginning at a young age that, left untreated, continue to worsen with age.

FH is relatively rare in the United States. An estimated 1 million U.S. adults have confirmed or probable FH.¹ Worldwide, about 1 in 311 people are estimated to have FH.²

If someone in your family has a heart attack early in life, talk with your health care team about your own and your other family members’ risk for FH and whether your family should get tested.

Your health care team may talk with you about lifestyle changes you can make to help lower or manage your cholesterol levels. Often, though, FH can’t be treated with lifestyle changes alone. You may need medicine, such as statin therapy or other medicine, to manage your cholesterol levels. Learn more about medicines to help lower your cholesterol.

What behaviors increase my risk for high cholesterol?

Your behaviors and lifestyle choices can increase your risk for high cholesterol.

• Eating a diet high in saturated fat and trans fat may contribute to high cholesterol and related conditions, such as heart disease.
• Not getting enough physical activity can make you gain weight, which can lead to high cholesterol. Learn more about how to get more physical activity into your day.
• Smoking damages your blood vessels, making them more likely to collect fatty deposits. Smoking may also lower high-density lipoprotein (HDL, or “good”) cholesterol levels. If you don’t smoke, don’t start. If you do smoke, learn more about tobacco use and ways to quit.

The good news is that healthy behaviors can lower your risk for high cholesterol.

What other factors increase my risk for high cholesterol?

Certain factors you cannot control increase your risk for high cholesterol:

• Family history. If you have a family history of high cholesterol, you are more likely to have high cholesterol. You may need to get your cholesterol levels checked more often than people who do not have a family history of high cholesterol. Learn more about why keeping track of your family health history is important.
• Age. Everyone’s risk for high cholesterol goes up with age. This is because as we age, our bodies can’t clear cholesterol from the blood as well as they could when we were younger. This leads to higher cholesterol levels, which raise the risk of heart disease and stroke.
• Sex. Until around age 55 (or until menopause), women tend to have lower low-density lipoprotein (LDL, or “bad”) levels than men do.³ At any age, men tend to have lower high-density lipoprotein (HDL, or “good”) cholesterol than women do.

Why should I keep track of my family health history?

Your risk for high cholesterol can increase even more if you have a family history of high cholesterol, do not eat a heart healthy diet, are sedentary, or smoke.

Family health history is a record of the diseases and health conditions in your family. Family health history is a useful tool for understanding health risks and preventing disease.

Visit Does it run in the family?, a website that gives the “why” and “how” behind collecting family health history information, tips for talking to family members, examples of conditions that can run in the family, and hints for health. The website has a customizable tool so that you can include personal health stories, photos, and health condition information.

More information

CDC

• About High Cholesterol
• About Heart Disease
• About Stroke
• Familial Hypercholesterolemia

Other organizations

• American Heart Association (AHA): Cholesterol
• Family Heart Foundation: Familial Hypercholesterolemia 101

References

1. Bucholz EM, Rodday AM, Kolor K, Khoury MJ, de Ferranti SD. Prevalence and Predictors of Cholesterol Screening, Awareness, and Statin Treatment Among US Adults With Familial Hypercholesterolemia or Other Forms of Severe Dyslipidemia (1999–2014). Circulation. 2018;137:2218–2230.
2. Hu P, Dharmayat KI, Stevens CAT, et al. Prevalence of Familial Hypercholesterolemia Among the General Population and Patients With Atherosclerotic Cardiovascular Disease. Circulation. 2020;141(22):1742-1759.
3. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25):e1082–e1143.