Which risk factors for high cholesterol are important?

During your exam, your doctor should assess your risk for heart disease, heart attack, stroke, and peripheral vascular disease. Be sure to talk with your doctor about your risk factors and what role they may play in your condition.

Risks for Heart Disease

Your doctor will talk with you about each of the following to assess your risk of heart disease.

  • Your age. You're at greater risk for heart disease if you're a man who is age 45 or older. Your risk is also greater if you are a woman who is age 55 or older or who has gone through menopause.
  • Your family history. You're at greater risk for heart disease if you have a close family member who has high cholesterol or heart disease or who has had a stroke. Close family members include your mother, father, sister, brother, or child. A complete family history will help your doctor determine whether you have an inherited disorder called familial hypercholesterolemia. See What Should I Tell My Doctor About My Family's Medical History?
  • Your smoking history. Smoking can lower your HDL - the good cholesterol - by as much as 15%. It can also damage your artery walls. Study results have shown that smoking is an important cause of unstable plaque. Unstable plaque is more likely to rupture or tear and cause blood clots. Clots can lead to heart attack, stroke, or circulation problems. In additon to these heart problems, smoking also increases your risk for lung cancer and other chronic lung disease.
  • Your blood pressure. Blood pressure readings of 140/90 mm Hg or higher increase your risk for heart disease.
  • Your diabetes status. If you are older than age 45 and haven't been tested recently for diabetes, your doctor may want to test you for it. Having diabetes increases your risk of high cholesterol and heart disease.
  • Your HDL cholesterol level. It is desirable to have your HDL - known as the good cholesterol - 40 mg/dL or higher.

If you have two or more major risk factors for heart disease as listed above, you and your doctor should then use a tool that estimates your risk of having a heart attack within the next 10 years. The tool calculates points based on your age, total cholesterol, HDL cholesterol, systolic blood pressure, treatment for high blood pressure, and whether you have smoked at all in the last month. This number is used to help guide the treatment of your high cholesterol. You can see a briefer version of this test yourself, by taking the National Cholesterol Education Program's Risk Assessment.

Risks for Heart Attack, High Cholesterol, and High Blood Pressure

Talk with your doctor about the following, too. They can affect your risk for heart attack, high cholesterol, and high blood pressure, as well as diabetes.

  • Your history of heart or blood vessel disease. You're more likely to have a heart attack if you have heart disease.
  • Your weight. Having a BMI greater than 27 puts you at greater risk for high cholesterol and heart disease.
  • Your physical activity level. If you're not physically active, you're at greater risk for heart disease. Also, exercise helps control cholesterol levels by increasing the good HDL and possibly decreasing the bad LDL levels.
  • Your diet. Eating a diet high in total fat, saturated fat, and cholesterol can increase your blood cholesterol and your risk for heart disease. Your doctor will want to know about your eating habits, especially how much total fat, saturated fat, and cholesterol you typically eat.