High cholesterol
How we measure and treat this common condition
Cholesterol is a type of fat in your blood that the body needs to build cells. However, when there is too much cholesterol in your blood, it can build up in the walls of the arteries. This can cause the arteries to harden and narrow, known as atherosclerosis, making it difficult for blood to flow through the body.
High cholesterol, also known as hypercholesterolemia, by itself does not cause symptoms, so you may not know your cholesterol is high. But if the artery becomes completely blocked, it can result in a heart attack or stroke.
In rare cases, high cholesterol can be caused by an inherited genetic mutation (familial hypercholesterolemia), but more often, it’s the result of unhealthy lifestyle choices.
Tests
We measure cholesterol with a simple blood test done after a nine- to 12-hour fast. The test tells us about your:
- Total cholesterol
- LDL (bad) cholesterol, the main source of blockage in the arteries
- HDL (good) cholesterol, which helps keep cholesterol from building up and protects against heart disease
- Triglycerides, another type of fat in your blood
Cholesterol is measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. Optimal levels for people without other health conditions are:
- Total cholesterol: Less than 200 mg/dL
- LDL (bad) cholesterol: Less than 100 mg/dL
- HDL (good) cholesterol: Above 60 mg/dL
- Triglycerides: Less than 100 mg/dL
Treatments
Making healthy lifestyle changes often is the first line of defense against high cholesterol. This can include:
- Eating a heart-healthy diet
- Exercising regularly
- Maintaining a healthy weight
If making these lifestyle changes isn’t enough to lower your cholesterol, your doctor may recommend medication, such as statins, bile acid sequestrants, or cholesterol absorption inhibitors.
Lipid disorders
Lipid disorders develop when fatty substances build up in the blood. These substances include cholesterol and triglycerides.
Left untreated, these buildups, commonly known as high cholesterol and high triglycerides, can lead to many other health problems, including high blood pressure and atherosclerosis (hardening of the arteries). They can also increase risk for heart disease and stroke.
At MedStar Health, our team of endocrinologists work with patients to manage lipid disorders, and coordinate care with other medical specialists, including cardiologists and vascular surgeons.
Among the lipid disorders we treat are:
- Hypercholesterolemia: High levels of cholesterol in the blood
- Hypertriglyceridemia: High levels of triglycerides in the blood
Treatment
Hypercholesterolemia: Lifestyle changes are usually the first line of treatment and include:
- Eating a heart-healthy diet that includes fiber-rich fruits and vegetables and avoids saturated fats, fast foods, and commercially baked products
- Exercising regularly
- Losing weight, if you are overweight
- Quitting smoking
There are a variety of medication options available to help lower cholesterol when diet and exercise are not enough. We will work with patients to prescribe a medication that will be most effective.
Hypertriglyceridemia: Conditions like obesity, diabetes, and hypothyroidism can lead to hypertriglyceridemia. Treatment starts by getting these underlying problems under control. We also recommend making lifestyle changes that include:
- Avoiding alcohol
- Eating a healthy diet that avoids excess calories and foods high in saturated fats and carbohydrates
- In some cases, medication is prescribed to help keep triglyceride levels under control, including statins and newer agents that are called PCSK9 inhibitors.
Hyperlipidemia
Excess lipids and other fatty substances in the blood can cause hyperlipidemia and other lipid disorders.
Our providers
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Sherrell I Apugo, CRNP
Urgent Care
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Megha Babu, MD
Internal Medicine
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Abigail Escalona Davenport, ACNP-BC
Cardiology
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Alexa Maria DiPeso, CRNP
Family Medicine
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Negar Foroughi Saeid, MD
Internal Medicine
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Margaret Harvey Granitto, CRNP
Cardiology
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Michealle Georgia Ann Harrison, CRNP
Internal Medicine
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Michele Cecile Henley, MD
Internal Medicine
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Nicole Lee, MD
Internal Medicine
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Esteban A. Marquez, MD
Internal Medicine
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Michael Evan Rigopoulos, PA
Internal Medicine
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Juliet Constance Russell, PA-C
Internal Medicine
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Alexander Ryzhikov, MD
Cardiology
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Elise Danielle Worley, DO
Urgent Care & Family Medicine
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Prashant Yamajala, MD
Family Medicine
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Sylvester Obanya Okonkwo, MD
Internal Medicine
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Our locations
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MedStar Washington Hospital Center
110 Irving St. NW Washington, DC 20010
MedStar Health: Medical Center at Chevy Chase
5454 Wisconsin Ave. Barlow Building 11th Fl. Chevy Chase, MD 20815
MedStar Health: Medical Center at Mitchellville
12158 Central Ave. Mitchellville, MD 20721
MedStar Montgomery Medical Center
18101 Prince Philip Dr. Olney, MD 20832
MedStar Health: Medical Center at Lafayette Centre
1133 21st St., NW Building 2 Washington, DC, 20036
Related services
Ask MedStar Heart & Vascular Institute
Have general questions for our heart and vascular program? Email us at AskMHVI@medstar.net. If you have clinically-specific questions, please contact your physician’s office.