An in-depth report on the diagnosis, treatment, and prevention of unhealthy cholesterol levels.

Total Cholesterol Goals

A blood test is used to measure cholesterol levels. A person's total cholesterol count includes measurements of low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides. Standard total cholesterol goals for adults are:

• Less than 200 mg/dL is desirable
• Between 200 - 239 mg/dL is considered borderline
• Over 240 mg/dL is considered high

Lifestyle Changes

The first step to improving cholesterol levels is through lifestyle changes (especially diet and exercise). Even when drug therapy is required, lifestyle changes are also necessary. These include:

• Eat a heart-healthy diet with plenty of fiber-rich fruits and vegetables. Avoid saturated fats (found mostly in animal products) and trans-fatty acids (found in fast foods and commercially baked products). Instead, choose unsaturated fats (particularly omega-3 fatty acids found in canola and fish oils).
• Exercise regularly. Studies have shown that regular aerobic exercise can help boost HDL ('good' cholesterol) levels.
• Quit smoking.
• No dietary supplements have been shown to improve cholesterol levels, and some can cause health risks. In 2007, the FDA issued a warning about red yeast rice products, many of which contain unauthorized use of prescription drugs.

Drug Therapy

A person's LDL ('bad' cholesterol) level generally determines if drug therapy is required. Most cholesterol drugs are used to help lower LDL levels. Some drugs are also used to help raise HDL levels. Drugs used in cholesterol treatment include:

• Statins
• Nicotinic acid (niacin)
• Bile-acid binding resins
• Fibrates
• Ezetimbe