About 11 percent of adults over 60 have high cholesterol in the United States. That may not cause any immediate problems. But too much cholesterol can increase your chances of heart problems.

Keep reading to learn more about the risks of high cholesterol in seniors.

Understanding cholesterol

Cholesterol isn’t always bad. In fact, your body needs it to make cells, hormones, and vitamins. It’s only when cholesterol levels are too high that it can become a problem.

What is cholesterol?

Cholesterol is a waxy, fat-like substance made in your liver. Your body uses it to digest fatty foods, make hormones, build healthy cells, and produce vitamin D. 

In your blood, it’s measured in milligrams per deciliter (mg/dL). Healthy total blood cholesterol levels are below 200 mg/dL. High cholesterol is a risk factor for heart disease. 

Blood cholesterol is different from dietary cholesterol. Dietary cholesterol comes from animal products like meat, poultry, seafood, dairy, and eggs. It's not a major driver of high blood cholesterol, but it’s still a good idea to limit it.

Types of cholesterol

There are two types of particles that are frequently called types of cholesterol: 

• Low-density lipoprotein (LDL)
• High-density lipoprotein (HDL) 

These particles are technically lipoproteins, meaning they’re made up of fats (lipids) and proteins. They technically aren’t cholesterol, but they transport cholesterol around your body.

LDL cholesterol

Low-density lipoproteins are also called LDL cholesterol or “bad” cholesterol. They can lead to a buildup of fatty deposits called plaque in your arteries. Plaques can clog arteries and increase your risk of having a stroke or heart attack.

Healthy LDL cholesterol levels are below 100 mg/dL (and the lower the better).

HDL cholesterol

High-density lipoproteins are also called HDL cholesterol or “good” cholesterol. They help flush cholesterol and plaque out of your body. They’re linked to a lower risk of health problems. 

Healthy HDL cholesterol levels are:

• 40 to 80 mg/dL in men
• 50 to 80 mg/dL in women

Risk factors of high cholesterol

Lifestyle factors like your diet and exercise habits are common risk factors for high cholesterol. Genetic factors and existing medical conditions also raise your odds of high cholesterol.

Common risk factors

Risk factors for cholesterol include:

• Eating a diet high in saturated or trans fats
• Having obesity
• Living a sedentary lifestyle
• Smoking cigarettes

Stress also changes levels of certain hormones. This might cause you to make more cholesterol. (Learn more about stress in seniors.)

Genetic risk

Some people have a genetic condition that causes very high LDL levels from birth. This is called familial hypercholesteremia, and it affects about 1 in every 200 to 500 people around the world. It can cause stroke and premature heart disease if it’s not caught and treated early.

Conditions that cause high cholesterol

Other health concerns can cause high cholesterol, too. Some of these you may have control over, while others you don’t:

• Diabetes
• Lupus
• Hypothyroidism
• Chronic liver disease
• Chronic kidney disease
• Sleep apnea

The impact of aging on cholesterol levels

High cholesterol is more common after 40. This is at least partly due to your liver. Later in life, your liver doesn’t remove LDL cholesterol from your body as well.

Plus, your lifestyle may have caught up with you. “Higher accumulated risk for increased cholesterol is a result of decades of unfavorable diet, lack of exercise, smoking, and stress,” says Bold Care provider Dr. Mitul Desai.

Hormonal changes

Women produce much less of the hormone estrogen after menopause. Estrogen helps maintain a healthy balance of LDL and HDL cholesterol. After menopause, women have a greater risk of cholesterol buildup.

Metabolic shifts

Body composition often changes with age. We naturally lose some lean muscle and tend to gain some body fat, especially belly fat. Having more body fat is linked with increased chances of high cholesterol. That means these changes may affect your cholesterol levels.

Symptoms of high cholesterol

There are typically no signs or symptoms of high cholesterol. That’s why it’s so important to get tested. Otherwise, you’d have no way of knowing if your cholesterol is high.

You may hear cholesterol testing referred to as a lipid panel. After 65, you’ll get screened every year. 

Risks associated with high cholesterol in seniors

As mentioned above, high cholesterol doesn’t usually cause any symptoms. But it can cause complications.

Heart health in seniors

High cholesterol can collect in plaques, or fatty deposits along artery walls. Over time, plaques can block blood flow. These blockages are dangerous because they can cause strokes and heart attacks.

If plaques tear or break, blood clots can form. Clots can block the flow of blood to the heart, causing a heart attack, or to the brain, causing a stroke.

Heart attacks and strokes are more common in older adults. Abnormal heart rhythms and thickening and stiffening of the walls and chambers of the heart are also more common with age. These changes can affect blood flow and contribute to the risk of heart problems. 

The connection between high cholesterol and high blood pressure

High blood pressure is another risk factor for heart health that you can control as you age. High blood pressure means the force of your blood against the walls of your arteries is consistently high. Like high cholesterol, it contributes to your risk of having a heart attack. 

“High cholesterol, especially LDL, enables plaques to deposit on artery walls. High blood pressure damages the lining of these arteries, making it easier for plaques to accumulate,” Dr. Desai says. “As the plaques build up, the arteries further stiffen, which raises blood pressure even more, leading to a vicious cycle.”

More than 60 percent of people with high blood pressure also have high cholesterol. But one doesn’t necessarily cause the other. Instead, there may be similar underlying risk factors for both. More research is needed to understand this connection. But managing both numbers is important for staying healthy as you age. 

Complications of high LDL cholesterol

LDL cholesterol is one of the components in the fatty deposits that can build up in your arteries. When this happens, it’s called atherosclerosis.

Atherosclerosis within the arteries of your heart is called coronary artery disease. Over time, these arteries harden and narrow, which may affect blood flow in your heart. This can cause chest pain and lead to a heart attack.

Strategies for managing cholesterol

Complications related to cholesterol are concerning. But there’s good news: Many of the most effective ways to manage cholesterol are things you can control.

Lifestyle changes

Small tweaks to your daily habits can lower your cholesterol. “Lifestyle changes are critically important in lowering cholesterol as they are the first-line of defense prior to initiating medications,” Dr. Desai says. “Making lifestyle changes provides sustainable results and may reduce the need for or supplement the effectiveness of medications.”

Here are some of the most important things to try.

Dietary changes

Wondering what foods lower cholesterol? Your best bet is limiting your intake of trans fats and saturated fats. Trans fat has been largely reduced in the U.S., but it may still be in some packaged foods in small amounts. Avoid foods that have “partially hydrogenated” ingredients on the label. 

Saturated fat comes from animal products, such as meat and dairy. You don’t have to avoid these foods completely if you have high cholesterol. But, you may want to limit how much red meat, butter, and cheese you eat.

There aren’t specific foods to lower cholesterol. But in general, a heart-healthy diet can support safe cholesterol levels.

Focus on eating:

• Fruits and vegetables in a variety of colors
• Lean protein from fish and plant-based sources like beans and legumes
• Whole grains

Consider talking to a Bold Care provider about the smartest diet changes for you.

Exercise

Regular physical activity can also help reduce or prevent high cholesterol. Exercise helps lower LDL and raise HDL.

There’s no best form of exercise for lowering cholesterol. What matters most is that you find what you enjoy so you're more likely to stick with it. Experiment with different types of movement until you find something you like. The CDC recommends aiming for 150 minutes of moderate-intensity cardio exercise per week. Try to get two muscle-strengthening sessions, too. And remember it’s OK to start with just a few minutes at a time and build up from there.

Not sure where to start? Try following along with a class or two on Bold’s exercise platform.

Stress management

Chronic stress may raise LDL and lower HDL. Plus, stress can also trigger chest pain or even a heart attack in people at risk.

Of course, some stress is unavoidable. But try to manage stress when it comes up.

There are lots of different stress-management tools to consider. Experiment with a few until you find what works best for you. Some options include:

• Meditating
• Deep breathing
• Journaling, reading, or creating art
• Talking with trusted loved ones
• Speaking with a mental health care professional
• Spending time in nature

Substance use management

Smoking can lower your “good” HDL cholesterol. Plus, smoking with high cholesterol increases your risk of heart problems even further. It also can make other heart-related concerns worse, such as high blood pressure.

When you quit smoking, your HDL may increase. Blood will flow through your arteries more easily.

That doesn’t mean quitting smoking is easy. You can talk to your Bold Care provider about strategies to quit smoking. They might recommend:

• Support from loved ones
• Seeking professional guidance
• Using nicotine-replacement products

Weight management

Carrying excess weight is associated with higher LDL. Extra fat tissue can slow down your ability to remove LDL from your blood.

That said, people in larger bodies can also have healthy cholesterol levels. Plus, losing weight alone may not be the key to healthy cholesterol for you. Talk to your Bold Care provider about weight management and the safest ways for you to lose or maintain your weight.

Cholesterol-lowering medication 

Lifestyle habits for managing cholesterol are important even if you try medication. These medications can give your body the extra support it needs to lower your levels. “Medications may be necessary for those who have extremely high levels of LDL or a genetic condition that causes high cholesterol,” Dr. Desai says. “Individuals who have diabetes or have experienced a prior cardiovascular event require cholesterol lowering medications to prevent further cardiovascular events.”

Your doctor may recommend a number of different types of cholesterol-lowering medications. That decision depends on your age, risk factors, and potential side effects. 

• Statins, such as atorvastatin and rosuvastatin, lower LDL by limiting how much cholesterol is produced in your liver.
• Ezetimibe lowers how much cholesterol is absorbed from food in your intestines.
• PCSK9 inhibitors, such as alirocumab and evolocumab, are shots given under your skin that help your liver absorb more LDL from your blood.
• ACLY inhibitors, such as bempedoic acid, work similarly to statins in that they block cholesterol production in your liver.
• Bile acid sequestrants, such as cholestyramine and colesevelam, prompt your liver to use more cholesterol to make bile acid, which lowers total cholesterol in your blood.

 Some medications may cause side effects, such as joint pain, fatigue, diarrhea, or cold symptoms. Statins may cause serious kidney and liver problems. Talk to a healthcare provider anytime you notice new symptoms you think might be due to a medication you’re taking.

Q&A

How can you increase HDL cholesterol?

Healthy lifestyle habits can help boost your “good” cholesterol. Try to eat more unsaturated fats, like those found in avocado and olive oil. Limit saturated fats, like those in red meat and dairy. Exercise regularly and avoid cigarettes. Losing excess weight may also improve your HDL.

What are 10 warning signs of high cholesterol?

Many people are curious about a simplified checklist of signs cholesterol is high. While that would be convenient, high cholesterol often doesn’t cause any symptoms. Think of “warning signs” as risk factors that contribute to high cholesterol, instead.

These include: 

• Eating a lot of saturated fat
• Getting too little exercise
• Having a family history of high cholesterol
• Experiencing a lot of stress
• Carrying excess body weight
• Smoking cigarettes

What reduces cholesterol quickly?

Similarly, many people hope for a fast fix for high cholesterol. Some even look for seven-day or 30-day solutions. But the most effective ways to lower your cholesterol, such as eating a healthy diet and exercising regularly, take time. “Maintaining consistency will eventually lead to habit changes that will lead to sustainable results,” Dr. Desai says.

Speak with a Bold Care provider about your cholesterol concerns. They can help advise you on the best next steps for your situation.