Hyperlipidemia (High Cholesterol): Causes, Risks & How to Lower It!

We often hear about cholesterol in terms of "good" and "bad," but what does that really mean for your health? Cholesterol is essential for building cells, producing hormones, and aiding digestion. However, when levels become too high—especially LDL cholesterol—it can build up in the arteries, increasing the risk of heart disease and stroke (AHA, 2023).

Hyperlipidemia is more common than many realize. Nearly 40% of adults in the U.S. have high cholesterol, yet most don’t experience symptoms. Many of my patients are surprised when they first see their cholesterol numbers. "But I feel fine!" they often say. The truth is, high cholesterol is silent—it’s what’s happening inside your arteries that matters.

The good news? High cholesterol is manageable. You can protect your heart and improve your overall health with the right combination of healthy habits, medication when needed, and regular monitoring.

What is Cholesterol?

Cholesterol is a fat-like substance found in every cell of the body. It plays a key role in producing hormones, vitamin D, and bile acids that help digest food. The body naturally produces cholesterol, but diet and lifestyle choices can influence how much circulates in the bloodstream.

There are two main types of cholesterol:

• LDL (low-density lipoprotein), often called "bad" cholesterol, contributes to plaque buildup in the arteries. Over time, LDL cholesterol builds up in the arteries, leading to atherosclerosis, or the hardening and narrowing of arteries, which increases the risk of heart disease.
• HDL (high-density lipoprotein), or "good" cholesterol, helps remove excess cholesterol from the bloodstream, carrying it to the liver for elimination.

Triglycerides are another type of fat in the blood. When triglyceride levels are high—especially alongside low HDL and high LDL—the risk of heart disease increases, as noted in AHA research on triglycerides and cardiovascular health. Factors like diet, alcohol intake, physical activity, and metabolic conditions can all impact triglyceride levels.

What Causes High Cholesterol and How to Lower It Naturally?

Cholesterol levels are influenced by lifestyle choices, genetics, and underlying health conditions.

Diet and Nutrition

What we eat has a direct impact on cholesterol. Diets high in saturated fats—found in red meat, full-fat dairy, and fried foods—can raise LDL cholesterol and contribute to plaque buildup. Processed foods and added sugars increase triglycerides, another factor in heart disease.

On the other hand, fiber-rich foods such as vegetables, beans, and whole grains help remove excess cholesterol before it can be absorbed into the bloodstream.

Physical Activity and Metabolism

Exercise is proven to increase HDL cholesterol while lowering LDL and triglycerides, supporting overall heart health. Even small, daily movements—such as walking after meals or taking the stairs—can make a difference.

Smoking and Alcohol

Tobacco use lowers HDL, making it harder for the body to clear LDL from the bloodstream. It also damages blood vessels, allowing cholesterol to build up more easily. Excessive alcohol consumption raises triglycerides, increasing the risk of heart disease and weight gain.

Weight and Metabolic Health

Carrying extra weight, particularly around the abdomen, disrupts cholesterol balance by raising LDL and triglycerides while lowering HDL. Even a modest weight loss of 5-10% can help improve cholesterol levels and overall heart health.

Genetics and Family History

Not all high cholesterol cases are linked to diet or lifestyle. Some people inherit a condition called familial hypercholesterolemia (FH), which leads to dangerously high LDL levels from birth (NHLBI, 2023). Early testing and monitoring are key to preventing long-term complications if high cholesterol runs in your family.

Underlying Health Conditions

Medical conditions such as diabetes, hypothyroidism, liver disease, and kidney disease can contribute to high cholesterol, making it harder to maintain a healthy balance. Insulin resistance, for example, is known to increase LDL and triglycerides while lowering HDL.

Why High Cholesterol is a "Silent" Condition

High cholesterol doesn’t cause symptoms, which is why many people don’t recognize the signs of high cholesterol levels until they get routine blood work—or worse, experience a serious health event like a heart attack or stroke.

Over time, LDL cholesterol builds up in the arteries, leading to atherosclerosis, or the hardening and narrowing of arteries. This restricts blood flow and increases the risk of:

• Heart disease – Plaque buildup can block arteries, cutting off oxygen to the heart.
• Stroke – A blood clot in a narrowed artery can block blood supply to the brain.
• Peripheral artery disease (PAD) – Narrowed arteries in the legs or arms can cause pain and circulation problems.

Because high cholesterol progresses silently, the only way to know your levels is through routine blood tests. Keeping cholesterol in check is one of the most important steps in protecting long-term health.

How to Lower Cholesterol Naturally

For many, high cholesterol can be managed—and even reversed—through lifestyle changes.

Heart-Healthy Eating

The best diet for high cholesterol includes fiber-rich foods like oats, beans, and whole grains, which help clear excess cholesterol before it can be absorbed into the bloodstream. Healthy fats from avocados, nuts, and olive oil raise HDL while lowering LDL. Limiting saturated fats, trans fats, and added sugars reduces LDL and triglycerides.

Staying Active

Regular physical activity improves cholesterol levels. Aim for at least 150 minutes of moderate exercise per week, such as brisk walking, swimming, or cycling. Strength training is also beneficial for overall metabolic health.

Weight Management

Even small weight loss (5-10%) can improve cholesterol levels, especially for those with excess abdominal fat.

Quitting Smoking and Limiting Alcohol

Quitting smoking leads to immediate improvements in HDL levels, helping the body clear excess cholesterol more efficiently. Cutting back on alcohol prevents triglyceride spikes, reducing cardiovascular risk.

When is Medication Needed?

Lifestyle changes are the first step in managing high cholesterol, but sometimes they’re not enough. If LDL is over 150, especially in people with diabetes, high blood pressure, a family history of heart disease, or other comorbidities, it’s important to discuss whether medication may help lower long-term risks.

Doctors may also consider cholesterol-lowering medication if:
✔ There’s a history of heart disease or stroke.
✔ Cholesterol remains high despite lifestyle changes.
✔ A genetic condition like familial hypercholesterolemia (FH) is present.

These lipid-lowering treatments work by reducing LDL production or helping the body clear excess cholesterol. When prescribed, they’re most effective alongside a heart-healthy lifestyle, not in place of one.

 

Final Thoughts: Take Control of Your Heart Health

Managing cholesterol doesn’t require drastic changes overnight. Small, consistent lifestyle adjustments can significantly improve heart health.

Staying proactive with regular cholesterol screenings, heart-healthy habits, and personalized medical guidance can make all the difference.

Ready to Take the Next Step?

📅 Schedule an Appointment Online
📞 Call: (212) 614-0039

Taking charge of your cholesterol today means a stronger heart and a healthier future. Let’s create a plan that works for you!

Resources

Cholesterol and Heart Disease Risk
Centers for Disease Control and Prevention (CDC, 2023):High Cholesterol Facts

Atherosclerosis and Cardiovascular Risk
American Heart Association (AHA, 2023): https://www.heart.org/en/health-topics/cholesterol

Familial Hypercholesterolemia and Genetic Risk
National Heart, Lung, and Blood Institute (NHLBI, 2023): https://www.nhlbi.nih.gov/health/familial-hypercholesterolemia

Impact of Triglycerides on Cardiovascular Health
Circulation Journal (AHA, 2021): https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.121.318083

Exercise and Cholesterol Management
JAMA Cardiology (2022): https://jamanetwork.com/journals/jamacardiology/fullarticle/2792176

Lipid-Lowering Treatment Recommendations
American Heart Association (AHA, 2023): https://www.ahajournals.org/doi/10.1161/HYP.0000000000000232

Resources

Cholesterol and Heart Disease Risk
Centers for Disease Control and Prevention (CDC, 2023): https://www.cdc.gov/cholesterol/facts.htm

Atherosclerosis and Cardiovascular Risk
American Heart Association (AHA, 2023): https://www.heart.org/en/health-topics/cholesterol

2023 Cholesterol Management Guidelines
American College of Cardiology (ACC, 2024): https://www.acc.org/Latest-in-Cardiology/Guidelines-and-Clinical-Documents

Familial Hypercholesterolemia and Genetic Risk
National Heart, Lung, and Blood Institute (NHLBI, 2023): https://www.nhlbi.nih.gov/health/familial-hypercholesterolemia

Impact of Triglycerides on Cardiovascular Health
Circulation Journal (AHA, 2021): https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.121.318083 

Exercise and Cholesterol Management
JAMA Cardiology (2022): https://jamanetwork.com/journals/jamacardiology/fullarticle/2792176

Lipid-Lowering Treatment Recommendations
American Heart Association (AHA, 2023): https://www.ahajournals.org/doi/10.1161/HYP.0000000000000232