National Cholesterol Education Month is a good time to learn about lipid profiles and about food and lifestyle choices that help you reach personal cholesterol goals. And is a good time to get your blood cholesterol checked and take steps to lower it, if it's high.

High blood cholesterol affects over 65 million Americans. Heart disease is the number one killer of women and men in the United States. Each year, more than a million Americans have heart attacks, and about a half million people die from heart disease. It is a serious condition that increases your risk for heart disease. The higher your cholesterol level is, the greater the risk. You can have high cholesterol and not know it. Lowering cholesterol levels that are too high lessens your risk for developing heart disease and reduces the chance of having a heart attack, stroke or even dying of heart disease.

What Is Cholesterol?To understand high blood cholesterol (ko-LES-ter-ol), it is important to know more about cholesterol. Cholesterol is a waxy, fat-like substance that is found in all cells of the body. Your body needs some cholesterol to work the right way. Your body makes all the cholesterol it needs. Cholesterol is also found in some of the foods you eat. Your body uses cholesterol to make hormones, vitamin D, and substances that help you digest foods.

Blood is watery, and cholesterol is fatty. Just like oil and water, the two do not mix. To travel in the bloodstream, cholesterol is carried in small packages called lipoproteins (lip-o-PRO-teens). The small packages are made of fat (lipid) on the inside and proteins on the outside. Two kinds of lipoproteins carry cholesterol throughout your body. It is important to have healthy levels of both: Low-density lipoprotein (LDL) cholesterol is sometimes called bad cholesterol. High LDL cholesterol leads to a buildup of cholesterol in arteries. The higher the LDL level in your blood, the greater chance you have of getting heart disease. High-density lipoprotein (HDL) cholesterol is sometimes called good cholesterol. HDL carries cholesterol from other parts of your body back to your liver. The liver removes the cholesterol from your body. The higher your HDL cholesterol level, the lower your chance of getting heart disease.

What Is High Blood Cholesterol?Too much cholesterol in the blood, or high blood cholesterol, can be serious. People with high blood cholesterol have a greater chance of getting heart disease. High blood cholesterol on its own does not cause symptoms; so many people are unaware that their cholesterol level is too high.

Cholesterol can build up on the walls of your arteries (blood vessels that carry blood from the heart to other parts of the body). This buildup of cholesterol is called plaque (plak). Over time, plaque can cause narrowing of the arteries. This is called arteriosclerosis (ath-er-o-skler-O-sis), or hardening of the arteries.

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An artery with normal blood flow (figure A) and an artery containing plaque buildup (figure B). Credit: National Institutes of Health

Arteriosclerosis is a disorder of the arteries. It occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard substances called plaque.

Eventually, the plaque deposits can make the artery less flexible. This makes it harder for blood to flow. If blood flow in the arteries leading to the heart is reduced, chest pain can occur. Plaques can also break apart, causing pieces of material to move through the artery. This is a common cause of heart attack and stroke. Blood clots can also form around the plaque deposits. Clots block blood flow. If the clot moves into the heart, lungs, or brain, it can cause a stroke, heart attack, or pulmonary embolism. Cerebrovascular disease, peripheral vascular disease, and kidney disease involving dialysis have also been linked to arteriosclerosis.

Special arteries, called coronary arteries, bring blood to the heart. Narrowing of your coronary arteries due to plaque can stop or slow down the flow of blood to your heart. When the arteries narrow, the amount of oxygen-rich blood is decreased. This is called coronary artery disease (CAD) is a condition in which plaque (plak) builds up inside the coronary arteries. These arteries supply your heart muscle with oxygen-rich blood. Large plaque areas can lead to chest pain called a ngina. Angina happens when the heart does not receive enough oxygen-rich blood. Angina is a common symptom of CAD.

Lowering your cholesterol level decreases your chance for having a plaque burst and cause a heart attack. Lowering cholesterol may also slow down, reduce, or even stop plaque from building up. Plaque and resulting health problems can also occur in arteries elsewhere in the body. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone-younger, middle age, and older adults; women and men; and people with or without heart disease.

Risk factors are conditions or behaviors that increase your chance of developing a disease. For heart disease, there are two types of risk factors-those you can't change and those you can. Fortunately, most of the heart disease risk factors can be changed.

Some risk factors you can't change, such as Age-45 or older for men; 55 or older for women. Family history of early heart disease-father or brother diagnosed before age 55, or mother or sister diagnosed before age 65.

Some risk factors you can change such as smoking, high blood pressure, high blood cholesterol, being overweight/obesity, physical inactivity and diabetes. Various factors can cause unhealthy cholesterol levels. Some of the factors cannot be changed but most can be modified. Those you cannot change-such as heredity the amount of LDL cholesterol your body makes and how fast it is removed from your body is determined partly by genes. High blood cholesterol can run in families. However, very few people are stuck with high cholesterol just by heredity and everyone can take action to lower their cholesterol. Furthermore, even if high cholesterol does not run in your family, you can still develop it. High cholesterol is a common condition among Americans, even young persons, and even those with no family history of it.

Things under your control in your diet that can make LDL levels rise are Saturated fat, a type of fat found mostly in foods that come from animals; Trans fat, found mostly in foods made with hydrogenated oils and fats such as stick margarine, crackers and french fries; and Cholesterol, which comes only from animal products. But it's important to know that saturated fat raises your LDL cholesterol level more than anything else in your diet. Diets with too much saturated fat, trans fat, and cholesterol are the main cause for high levels of blood cholesterol-a leading contributor to the high rate of heart attacks among Americans. Also being overweight tends to increase your LDL level. It typically raises triglycerides, a fatty substance in the blood and in food and lowers HDL. Losing the extra pounds may help lower your LDL and triglycerides, while raising your HDL.

What Is Your Cholesterol Numbers? Everyone age 20 and older should have his or her cholesterol measured at least once every 5 years. It is best to have a blood test called a "lipoprotein profile" to find out your cholesterol numbers. This blood test is done after a 9- to 12-hour fast and gives information about your:

Total cholesterol

LDL (bad) cholesterol - the main source of cholesterol buildup and blockage in the arteries

HDL (good) cholesterol - helps keep cholesterol from building up in the arteries

Triglycerides - another form of fat in your blood

If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL* or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done.

If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL* or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done. See how your cholesterol numbers compare to the tables below.

Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease. Triglycerides can also raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people.

Please contact your doctor and get your Cholesterol checked. A simple test could save you life.

The National Heart, Lung, and Blood Institute offer helpful resources to use during National Cholesterol Education Month.