High Cholesterol & Heart Specialist

What Is High Cholesterol?

Cholesterol is a waxy substance your body needs to build cells, produce hormones, and perform other essential functions. Your liver produces the cholesterol your body needs, and additional cholesterol comes from certain foods.

High cholesterol, also called hypercholesterolemia, occurs when too much cholesterol—particularly low-density lipoprotein cholesterol, or LDL—circulates in your blood.

Over time, excess LDL cholesterol can contribute to plaque buildup inside the arteries. This process, known as atherosclerosis, can narrow or block blood vessels and increase the risk of:

• Coronary artery disease
• Heart attack
• Stroke
• Peripheral artery disease
• Other cardiovascular complications

High cholesterol usually causes no warning signs, making routine testing and early treatment especially important.

What Do LDL, HDL, and Triglycerides Mean?

A cholesterol test, also called a lipid panel, measures several types of fat in your blood:

LDL Cholesterol

LDL is commonly called “bad” cholesterol because elevated levels can contribute to plaque buildup in the arteries. For most patients, lowering LDL is the primary focus of cholesterol treatment.

HDL Cholesterol

HDL is often called “good” cholesterol because it helps transport cholesterol away from the arteries and back to the liver. However, HDL should be interpreted as part of your complete cardiovascular risk profile rather than used as a treatment target by itself.

Triglycerides

Triglycerides are fats your body uses to store energy. Elevated triglycerides—especially when combined with high LDL or low HDL—may increase cardiovascular risk. Extremely high triglyceride levels can also increase the risk of pancreatitis.

Total Cholesterol

Total cholesterol reflects the combined cholesterol carried by different lipoproteins in your blood. It is useful as a screening measurement, but it should not be interpreted on its own.

What Should My Cholesterol Levels Be?

There is no single cholesterol goal that is right for every patient.

Your ideal LDL and non-HDL cholesterol levels depend on your overall cardiovascular risk, including:

• Age
• Blood pressure
• Diabetes or kidney disease
• Tobacco use
• Family history
• Previous heart attack or stroke
• Evidence of plaque in the arteries
• Other cardiovascular risk factors

An LDL level that may be acceptable for a person at low risk could be too high for someone with diabetes, known cardiovascular disease, or a strong family history of premature heart disease.

At Vivify Medical, we evaluate your cholesterol results in the context of your complete health—not as isolated numbers.

Are There Different Types of High Cholesterol?

Yes. Abnormal cholesterol and triglyceride levels are collectively known as dyslipidemia. Common forms include:

High LDL Cholesterol

Elevated LDL is one of the most important modifiable risk factors for atherosclerosis, heart attack, and stroke.

High Triglycerides

Triglycerides may rise because of excess weight, diabetes, alcohol use, certain medications, genetics, or a diet high in refined carbohydrates and added sugars.

Mixed Dyslipidemia

Some patients have both elevated LDL cholesterol and elevated triglycerides, sometimes accompanied by low HDL cholesterol.

Familial Hypercholesterolemia

Familial hypercholesterolemia, or FH, is an inherited condition that can cause very high LDL cholesterol from an early age. Patients may need earlier and more intensive treatment to reduce their lifetime cardiovascular risk.

Secondary Dyslipidemia

Cholesterol levels can also be affected by underlying conditions or medications. Possible contributors include:

• Diabetes
• Hypothyroidism
• Kidney or liver disease
• Obesity
• Excessive alcohol intake
• Certain prescription medications

Identifying the type and underlying cause helps us develop a more effective treatment plan.

What Are the Risk Factors for High Cholesterol?

High cholesterol may affect anyone, but several factors can increase your risk:

• Family history of high cholesterol or early heart disease
• A diet high in saturated fat or heavily processed foods
• Physical inactivity
• Overweight or obesity
• Tobacco use
• Diabetes or insulin resistance
• Kidney disease
• Hypothyroidism
• Excessive alcohol consumption
• Increasing age

Some risk factors can be improved through lifestyle changes, while genetic and medical contributors may require additional treatment.

Symptoms of High Cholesterol

High cholesterol usually has no symptoms.

You can feel completely healthy while plaque gradually develops inside your arteries. A blood test is the only reliable way to identify abnormal cholesterol levels.

In rare cases, inherited conditions such as familial hypercholesterolemia may produce visible cholesterol deposits around the eyes or in tendons. Most patients, however, will have no outward warning signs.

Symptoms such as chest pain, sudden shortness of breath, facial drooping, weakness on one side, or difficulty speaking may indicate a heart attack or stroke—not cholesterol itself—and require immediate emergency care.

How Is High Cholesterol Diagnosed?

High cholesterol is diagnosed with a blood test called a lipid panel. Depending on your circumstances, you may or may not need to fast before testing.

A standard lipid panel typically measures:

• LDL cholesterol
• HDL cholesterol
• Triglycerides
• Total cholesterol
• Non-HDL cholesterol

Your evaluation may also include:

• Personal and family medical history
• Blood pressure measurement
• Diabetes and metabolic-risk assessment
• Review of diet, exercise, tobacco, and alcohol use
• Evaluation for conditions that may affect cholesterol
• Review of current medications

For selected patients, additional testing may provide a clearer picture of cardiovascular risk. This can include apolipoprotein B, lipoprotein(a), or a coronary artery calcium scan.

Lipoprotein(a), also called Lp(a), is largely determined by genetics and may increase cardiovascular risk even when a standard cholesterol panel appears reassuring. Current guidance recommends that adults have Lp(a) measured at least once.

How Is High Cholesterol Treated?

At Vivify Medical, treatment is personalized according to your cholesterol levels, medical history, and overall risk of heart attack and stroke.

Our philosophy is “less medication, more life.” Lifestyle is the foundation of treatment, while medication is used thoughtfully when it provides meaningful protection.

Lifestyle Optimization

Your plan may include:

• Eating more vegetables, fruits, legumes, whole grains, nuts, and fiber-rich foods
• Choosing fish, plant proteins, and lean sources of protein
• Reducing saturated fat, trans fat, and heavily processed foods
• Limiting refined carbohydrates, added sugars, and excessive alcohol
• Increasing regular physical activity
• Reaching or maintaining a healthy weight
• Avoiding tobacco and vaping
• Improving sleep and managing stress

Small, sustainable changes can produce meaningful improvements and support lifelong cardiovascular health.

When Is Cholesterol Medication Needed?

Medication may be recommended when lifestyle changes alone are unlikely to reduce cardiovascular risk sufficiently.

Factors that may support medication include:

• Known coronary artery disease, stroke, or peripheral artery disease
• Very high LDL cholesterol
• Diabetes or chronic kidney disease
• Familial hypercholesterolemia
• Plaque identified through cardiovascular imaging
• Elevated calculated risk of heart attack or stroke
• Cholesterol that remains above your personalized goal despite lifestyle changes

Statins remain the first-line medication for many patients because they lower LDL cholesterol and reduce the risk of heart attack and stroke.

Depending on your needs and response to treatment, additional options may include ezetimibe, bempedoic acid, PCSK9-targeting therapies, or medications for significantly elevated triglycerides.

Treatment decisions are made collaboratively. We consider the expected benefits, possible side effects, your preferences, and the approach you are most likely to maintain.

Why Choose a Cardiologist for High Cholesterol?

High cholesterol is more than an abnormal laboratory result—it is a major contributor to cardiovascular disease.

A cardiology-led approach provides:

• Personalized heart attack and stroke risk assessment
• Evaluation for existing coronary or vascular disease
• Identification of inherited cholesterol disorders
• Interpretation of advanced lipid testing when appropriate
• Selective use of coronary artery calcium scoring
• Individualized cholesterol and cardiovascular-risk goals
• Integrated management of blood pressure, diabetes, and other heart risks
• Long-term monitoring of treatment effectiveness and safety

Earlier identification and treatment can reduce lifelong exposure to plaque-forming cholesterol and help prevent serious cardiovascular complications.