A simple blood test at your regular preventive care visit will tell you what your levels of total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides are. If results show that your numbers are too high, you’re not alone: About 74 million U.S. adults have high cholesterol, but less than half of them are getting treatment to lower their cholesterol and protect their heart health, according to the Centers for Disease Control and Prevention (CDC). Read on to get the facts about cholesterol.

  1. You can’t live without cholesterol. We’re born with cholesterol in our bodies, and infants get more from their mother’s milk; in fact, cholesterol is even added to baby formula. Cholesterol is essential because all of our hormones and cells need it to function properly. It’s also a building block for all of the body’s cells, and it helps the liver make acids that are required to process fat.
  2. One out of every three adults has high cholesterol. All people over age 20 should get their cholesterol checked with a simple blood test every five years, according to the CDC, but only about 75 percent of them do. This number is disconcerting considering that about 32 percent of U.S. adults have high LDL levels that put them at a higher risk for heart disease. And because cholesterol levels can be affected by many different things — diet and stress, for example — the most accurate results can be obtained when two separate tests are performed a week apart, says Stephen Kopecky, MD, a cardiologist at the Mayo Clinic in Rochester, Minnesota. Yet many physicians don’t follow this testing recommendation, he says.
  3. High cholesterol could be genetic. A lot of focus is placed on controlling cholesterol levels through dietary changes and exercise, but the main influencing factor is genetics. “Seventy-five percent of cholesterol is due to genes, and about 25 percent is due to diet,” says Dr. Kopecky about the levels of cholesterol in your blood. When you eat foods that contain cholesterol, like meat, fish, and dairy, your body gets rid of the excess if it’s functioning normally. But how much cholesterol you get rid of depends on your genes. People with familial hypercholesterolemia (FH), for example — an inherited condition that affects about 1 in 200 people (up to 34 million people worldwide) — can’t effectively lose the excess. You may have FH if your family has a history of high cholesterol or early heart attacks (occuring before age 50). Be sure to see your doctor to get your cholesterol levels tested if you fall into this category.
  4. Even children can have high cholesterol. Most people think of high cholesterol as an adult’s issue, but the healthcare community now knows that one key to keeping levels normal is to start testing early. The American Academy of Pediatrics recommends cholesterol screening for all kids between ages 9 and 11. And selective screening should be done even earlier — beginning at age 2 — for children at high risk of having cholesterol issues, including kids with:

ObesityA family history of heart attacksA family history of high cholesterol

“Even if people know their cholesterol is high and they’ve talked about it with their siblings, doctors don’t always tell them that their kids need to get checked,” says Martha Gulati, MD, chief of cardiology at the University of Arizona College of Medicine in Phoenix. “They should ask their doctor about this, especially if they have a family history of premature heart disease.” 5. Sweating can raise your good cholesterol levels. Aside from eating a healthy diet, including foods like heart-healthy salmon and avocado, you can raise your HDL levels — which protect against heart disease — by working out. The key, says Kopecky, is to use interval training by exercising at a medium-intensity, sprinkling in bouts of high-intensity. In a study of women with type 2 diabetes published in June 2016 in the International Journal of Sports Medicine, three weeks of high-intensity interval training significantly boosted the women’s HDL levels by 21 percent and lowered trigylcerides by 18 percent. And a study published in March 2009 in the Journal of Strength and Conditioning Research found that men who jogged and then ran at a high intensity for equal periods of time saw significant improvement in their HDL levels over eight weeks compared with people in the control group. 6. Supplements may work to lower cholesterol — but slowly. Unless you’re at high risk for a heart attack or have familial hypercholesterolemia, diet and exercise are your first options to lower cholesterol. And many people who have high cholesterol don’t want to go on cholesterol medication, says Kopecky. Luckily, eating a healthy diet and supplementing it with 2 to 3 grams of plant stanols and sterols daily can reduce LDL by 6 to 15 percent, according to the Cleveland Clinic in Ohio, thereby reducing your risk of heart disease. The main drawback of supplements is that they have to be taken daily, and they don’t work overnight. But cholesterol-lowering medications such as statins work faster. “You can take a cholesterol-lowering pill today, and [your levels] will be down by 3 to 4 percent tomorrow,” Kopecky says. “It takes a few months for lifestyle changes and supplements to make a difference.” In addition, the magnitude of the decline in cholesterol levels is often not as great with diet and exercise as it is with medication. RELATED: 8 Foods to Help Lower Your Cholesterol 7. The number of people who should be on cholesterol-lowering meds is on the rise. The medical community used to be somewhat reserved about recommending cholesterol-lowering medication: Statins were suggested for people who had a risk of heart attack above 20 percent in the next 10 years. But the current American Heart Association guidelines recommend statin treatment for people with a 7.5 percent or higher chance of having a heart attack or stroke in the next decade. You may also need medication to treat high cholesterol if you:

Have had a heart attack, stroke, angina, or peripheral artery diseaseHave very high LDL levels (190 mg/dl or higher) or have familial hypercholesterolemiaHave diabetes and are between ages 40 and 75

  1. The woman depicted in the “Mona Lisa” may have had high cholesterol. Did you know you might be able to tell if someone has familial hypercholesterolemia just by looking at them? It’s possible, which is why one researcher says the subject of Leonardo da Vinci’s the “Mona Lisa” may have been the first known case. Da Vinci’s muse, who was painted in her twenties and passed away in her thirties, appears to have had visible traits of the condition: a xanthelasma (a yellowish fatty deposit) in her left eye and possibly on her left hand, too.
  2. Women’s cholesterol levels fluctuate over their lifespan. Though women tend to have lower cholesterol levels than men, they may experience a roller coaster ride in levels throughout their lives. During pregnancy, a woman’s cholesterol levels rise, which is thought to help babies’ brains develop. And cholesterol-rich breast milk is thought to be heart-protective for babies as they age. Post-pregnancy, cholesterol levels should return to normal, says Kopecky. But after menopause, women’s LDL cholesterol levels go up, while protective HDL levels decline, notes the Cleveland Clinic. By age 75, women tend to have higher cholesterol levels than men.
  3. Your cholesterol levels might be on the borderline. According to the CDC, the average total cholesterol of Americans over age 20 is 192 mg/dl. This is concerning, considering that a borderline high cholesterol level is 200 mg/dl; high is more than 240 mg/dl. But remember that as with many measurements, different people strive for different numbers. If you are concerned, talk with your doctor about setting your individual cholesterol goals.