This silent factor raises your risk of heart attacks or stroke.

Nearly 100 million U.S. adults have unhealthy cholesterol levels, and many do not know it since there are often no signs or symptoms.

What is cholesterol?

Cholesterol is a type of fat (lipid) in your blood. Your cells need cholesterol, and your body makes all it needs. But you also get cholesterol from the food you eat.

If you have too much cholesterol, it starts to build up in your arteries (the blood vessels that carry blood away from the heart.) This is called hardening of the arteries, or atherosclerosis. This is the starting point for some heart and blood flow problems. The buildup can narrow the arteries and make it harder for blood to flow through them. The buildup can also lead to dangerous blood clots and inflammation that can cause heart attacks and strokes.

There are two types of cholesterol.

• LDL is the "bad" cholesterol that can raise your risk of heart disease, heart attack, and stroke.
• HDL is the "good" cholesterol that is linked to a lower risk of heart disease, heart attack and stroke.

Why does cholesterol matter?

Early diagnosis and management is important in preventing heart attacks and strokes. Other factors your doctor can use to calculate your risk include:

• Your blood pressure.
• Whether or not you have diabetes.
• Your age, sex and race.
• Whether or not you smoke.

How are cholesterol levels tested? 

You need a blood test to check both kinds of cholesterol.

A cholesterol test, also called a lipid panel, measures all of the fats in your blood, including total, LDL and HDL cholesterol.

High cholesterol levels don't make you feel sick. So, the blood test is the only way to know your cholesterol levels.

What affects cholesterol levels? 

Many things can affect cholesterol levels, including:

• The foods you eat. Eating too much saturated fat and trans fat can raise your cholesterol.
• Being overweight. This may lower HDL ("good") cholesterol.
• Being inactive. Not exercising may lower HDL ("good") cholesterol.
• Age. Cholesterol starts to rise after age 20.
• Family history. If family members have or had high cholesterol, you may also have it.

How can you manage your cholesterol? 

Medicines and lifestyle choices can help you manage your cholesterol.

How you choose to manage your cholesterol and lower your risk for heart attack and stroke will depend on a variety of factors.

How do you feel about taking medicines? Are you taking several and would you rather try to manage your cholesterol without them? Knowing and balancing the benefits and risks of your treatment options can help you. Either way, it’s incredibly important to not delay routine care—even during a pandemic.

Statin medicine

• For people whose chance of having a heart attack or stroke is high, taking a statin can be helpful.
• For others, it may not be as clear whether taking statins is ideal. You and your doctor will need to look at your overall health to determine if this is right for you.

Lifestyle changes

• Eating a heart-healthy diet that is rich in fruits, vegetables, whole grains, fish, and low-fat or nonfat dairy foods.
• Being active on most, if not all, days of the week.
• Losing weight if you need to and staying at a healthy weight.
• Avoid or quit smoking.
• Be sure to receive your COVID-19 vaccine when it is available to you to avoid the extra risk factors that can come with complications from COVID-19. 

Changing old habits may not be easy, but it is very important to help you live a healthier and longer life. Having a plan can help. Start with small steps. For example, commit to adding one fruit or one vegetable a day for a week. Instead of having dessert, take a short walk.

With clear information, you can take the steps you need to take control.