LDL: The "Bad" Cholesterol
Also called: Low-density lipoprotein
What is cholesterol?
Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.
Cholesterol travels through the blood on proteins called “lipoproteins.” Two types of lipoproteins carry cholesterol throughout the body
What are LDL and HDL?
LDL and HDL are two types of lipoproteins. They are a
combination of fat (lipid) and protein. The lipids need to be attached to the
proteins so they can move through the blood. LDL and HDL have different
purposes:
LDL (low-density lipoprotein), sometimes called “bad” cholesterol,
makes up most of your body’s cholesterol. High levels of LDL cholesterol raise
your risk for heart disease and stroke.
LDL stands for low-density lipoproteins. It is sometimes
called the "bad" cholesterol because a high LDL level leads to a
buildup of cholesterol in your arteries.
HDL stands for high-density lipoproteins. It is sometimes
called the "good" cholesterol because it carries cholesterol from
other parts of your body back to your liver. Your liver then removes the
cholesterol from your body.
How can a high LDL level raise my risk of coronary artery
disease and other diseases?
If you have a high LDL level, this means that you have too
much LDL cholesterol in your blood. This extra LDL, along with other
substances, forms plaque. The plaque builds up in your arteries; this is a
condition called atherosclerosis.
When your body has too much LDL cholesterol, the LDL cholesterol can build up on the walls of your blood vessels. This buildup is called “plaque.” As your blood vessels build up plaque over time, the insides of the vessels narrow. This narrowing blocks blood flow to and from your heart and other organs. When blood flow to the heart is blocked, it can cause angina (chest pain) or a heart attack.
Coronary artery disease happens when the plaque buildup is
in the arteries of your heart. It causes the arteries to become hardened and
narrowed, which slows down or blocks the blood flow to your heart. Since your
blood carries oxygen to your heart, this means that your heart may not be able
to get enough oxygen. This can cause angina (chest pain), or if the blood flow
is completely blocked, a heart attack.
How do I know what my LDL level is?
A blood test can measure your cholesterol levels, including LDL. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:
For people who are age 19 or younger::
The first test should be between ages 9 to 11
Children should have the test again every 5 years
Some children may have this test starting at age 2 if there
is a family history of high blood cholesterol, heart attack, or stroke
For people who are age 20 or older::
Younger adults should have the test every 5 years
Men ages 45 to 65 and women ages 55 to 65 should have it
every 1 to 2 years
What can affect my LDL level?
Things that can affect your LDL level include:
Diet. Saturated fat and cholesterol in the food you eat make
your blood cholesterol level rise
Weight. Being overweight tends to raise your LDL level,
lower your HDL level, and increase your total cholesterol level
Physical Activity. A lack of physical activity can lead to
weight gain, which can raise your LDL level
Smoking. Cigarette smoking lowers your HDL cholesterol.
Since HDL helps to remove LDL from your arteries, if you have less HDL, that
can contribute to you having a higher LDL level.
Age and Sex. As women and men get older, their cholesterol
levels rise. Before the age of menopause, women have lower total cholesterol
levels than men of the same age. After the age of menopause, women's LDL levels
tend to rise.
Genetics. Your genes partly determine how much cholesterol
your body makes. High cholesterol can run in families. For example, familial
hypercholesterolemia (FH) is an inherited form of high blood cholesterol.
Medicines. Certain medicines, including steroids, some blood
pressure medicines, and HIV/AIDS medicines, can raise your LDL level.
Other medical conditions. Diseases such as chronic kidney
disease, diabetes, and HIV/AIDS can cause a higher LDL level.
Race. Certain races may have an increased risk of high blood
cholesterol. For example, African Americans typically have higher HDL and LDL
cholesterol levels than whites.
What should my LDL level be?
With LDL cholesterol, lower numbers are better, because a high LDL level can raise your risk for coronary artery disease and related problems:
How can I lower my LDL level?
There are two main ways to lower your LDL cholesterol:
Therapeutic lifestyle changes (TLC). TLC includes three
parts:
Heart-healthy eating. A heart-healthy eating plan limits the
amount of saturated and trans fats that you eat. Examples of eating plans that
can lower your cholesterol include the Therapeutic Lifestyle Changes diet and
the DASH eating plan.
Weight Management. If you are overweight, losing weight can
help lower your LDL cholesterol.
Physical Activity. Everyone should get regular physical
activity (30 minutes on most, if not all, days).
Drug Treatment. If lifestyle changes alone do not lower your
cholesterol enough, you may also need to take medicines. There are several
types of cholesterol-lowering drugs available, including statins. The medicines
work in different ways and can have different side effects. Talk to your health
care provider about which one is right for you. While you are taking medicines
to lower your cholesterol, you still should continue with the lifestyle changes.
Some people with familial hypercholesterolemia (FH) may
receive a treatment called lipoprotein apheresis. This treatment uses a
filtering machine to remove LDL cholesterol from the blood. Then the machine
returns the rest of the blood back to the person. (read more other topics)
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