Overview

Our bodies need some cholesterol to work properly. But too much can be harmful. Over time, cholesterol and fat can collect in the inner walls of the arteries – including the ones that supply blood to the heart. This buildup can cause atherosclerosis, which is a major cause of heart and blood vessel disease.

People with higher levels of low-density lipoprotein, or LDL, cholesterol are more likely to have a heart attack or a stroke. About 1 in 5 adults also have high levels of another type of lipoprotein called lipoprotein (a) or "LP-little A." Much like LDL cholesterol, high Lp(a) raises one’s heart disease risk.

Cholesterol comes from two main sources:

• The liver, which makes cholesterol naturally

• Foods we eat, especially those high in certain fats

Cholesterol plays several important roles in the body. It helps:

• Form the outer coating of our cells

• Make vitamin D and certain hormones

• Produce bile acids that help digest fats

But eating too much unhealthy saturated or trans fat can raise cholesterol levels in the blood, increasing the chance of heart disease. These foods include:

• Full-fat dairy (whole milk, cheese)

• Fatty or dark meats

• Ultra processed or fried foods and those prepared with butter, shortening or partially hydrogenated oils and sweets (cookies and cakes)

LDL cholesterol is most commonly talked about and focused on when it comes to cholesterol and lowering one’s risk of heart events and stroke. But LDL cholesterol is just one type of blood lipid.

Other lipids that play a role include your:

• High-density lipoprotein (HDL)

• Triglycerides

• Non-HDL cholesterol, which estimates the overall number of cholesterol particles (like LDL cholesterol) that have the potential to lead to a buildup of fat and plaque in the walls of the heart’s arteries.

• Lipoprotein(a), which should be checked once in adulthood as it’s genetically determined, and mostly stays the same

• Apolipoprotein B, which is especially helpful if you have type 2 diabetes, high triglycerides, or have heart disease, kidney disease, diabetes and obesity

Together, these and other lipids can help give a better picture of your overall heart risk.