Cholesterol levels vary by age, weight, and sex. They typically increase over time, and people over 20 should check their cholesterol levels every 5 years.
The Centers for Disease Control and Prevention (CDC) estimates that nearly 94 million adults in the United States have high cholesterol. This increases a person’s risk of heart disease and stroke.
In this article, we look at how doctors measure cholesterol and the healthy levels at different stages of life. We also look at ways of lowering cholesterol and maintaining acceptable levels.
What is cholesterol, and how do doctors measure it?
Cholesterol is a waxy, fat-like substance. There are two types: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
If there is too much LDL or “bad” cholesterol in the bloodstream, it can build up in blood vessels, forming fatty deposits called plaques. These plaques can lead to other problems, including heart attacks and strokes.
Total and LDL cholesterol levels should be low. But having more HDL or “good,” cholesterol in the blood may reduce the risk of a heart attack or stroke. Doctors can measure HDL, LDL, and total cholesterol levels. The results may also show levels of all non-HDL fats that can raise the risk of heart disease.
Cholesterol levels and age
Cholesterol levels tend to increase with age. Taking steps to reach or maintain healthy levels earlier in life may prevent them from becoming dangerously high over time. Years of unmanaged cholesterol levels can be challenging to treat.
The CDC recommends that people aged 20 or over check their cholesterol levels at least once every 4–6 years or more frequently if they have other cardiovascular disease risk factors.
Children should have at least one cholesterol test at age 9–11 and another one at age 17–21. However, children with risk factors for high cholesterol may need more frequent checks.
Typically, males tend to have higher levels throughout their lives than females. A male’s cholesterol levels increase with age, and a female’s cholesterol levels rise after menopause.
The table below shows healthy levels of cholesterol by age, according to the National Institutes of Health (NIH). Doctors measure cholesterol in milligrams per deciliter (mg/dl).
Type of cholesterol | Anyone 19 or younger | Males aged 20 or over | Females aged 20 or over |
Total cholesterol | less than 170 mg/dl | 125–200 mg/dl | 125–200 mg/dl |
Non-HDL | less than 120 mg/dl | less than 130 mg/dl | less than 130 mg/dl |
LDL | less than 100 mg/dl | less than 100 mg/dl | less than 100 mg/dl |
HDL | more than 45 mg/dl | 40 mg/dl or higher | 50 mg/dl or higher |
What is the normal range for cholesterol?
For adults aged 20 and over, the following levels are significant:
Type of cholesterol | Acceptable | Near optimal | Borderline high | High | Very high |
Total cholesterol | below 200 mg/dl | n/a | 200–239 mg/dl | 240 mg/dl or above | n/a |
LDL | below 100 mg/dl | 100–129 mg/dl | 130–159 mg/dl | 160–189 mg/dl | 190 mg/dl or over |
For HDL cholesterol, higher levels are linked to a reduced risk of heart disease:
Type of cholesterol | Acceptable | Borderline low | Risk of heart disease |
HDL | 60 mg/dl and above | 40–59 mg/dl | below 40 mg/dl |
Aging aside, any changes in cholesterol levels usually stem from health conditions and lifestyle factors. Below, we describe healthy and unhealthy ranges in more detail.
Cholesterol levels for adults
A doctor may classify a person’s levels as high or low, borderline, or healthy.
Ideally, LDL cholesterol levels should be less than 100 mg/dl. Doctors may not express concern about levels of 100–129 mg/dl for people with no health issues, but they may suggest treatment at this stage for people with heart disease or its risk factors.
Cholesterol levels for children
According to the American Academy of Pediatrics, the following measures apply for children and adolescents aged 19 and below:
Cholesterol type | Acceptable | Borderline high | High |
Total cholesterol | below 170 mg/dl | 170–199 mg/dl | 200 mg/dl or above |
LDL | below 100 mg/dl | 100–129 mg/dl | over 130 mg/dl |
Other factors that affect blood cholesterol
The CDCTrusted Source point outs that some health conditions and lifestyle factors can raise cholesterol levels. It says that type 2 diabetes, for example, raises LDL cholesterol levels, as does familial hypercholesterolemia.
The CDC also states that having a diet high in saturated fats and getting low levels of exercise may contribute to high cholesterol levels.
In addition, it acknowledges that having family members with high cholesterol increases a person’s risk.
How to lower cholesterol
The NIH recommends these strategies for lowering cholesterol levels:
having a diet rich in heart-healthyTrusted Source foods, including plenty of fruits and vegetables, lean proteins, and whole grains
becoming more physically active
quitting smoking, if this applies
having a moderate weight
managing stress
The NIH recommends consulting a healthcare professional before starting a new exercise plan. Overall, current guidelines advise people to aim for at least 150 minutes per week of moderate-intensity exercise as well as muscle-strengthening exercise 2 days per week.
Having a healthy diet and getting plenty of exercise can also bring down high cholesterol levels in children.
Generally, the earlier a person starts making these changes, the better for their cholesterol levels, as cholesterol builds up over time.
High cholesterol at any age increases the risk of heart disease, heart attack, and stroke.
These risks only increase over time.
Drug therapies to treat high cholesterol
When lifestyle changes alone cannot bring down high cholesterol, doctors may recommend medications. The CDC reports that the following drugs and supplements can help:
Statins: Statins keep the liver from producing cholesterol and are the most common medication for high cholesterol.
Bile acid sequestrants: These drugs reduce the amount of fat that the body absorbs from food.
Cholesterol absorption inhibitors: These drugs lower levels of fats called triglycerides in the blood and reduce the amount of cholesterol absorbed from food.
Some vitamins and supplements: These, such as niacin, stop the liver from removing HDL and lower levels of triglycerides.
Omega-3 fatty acids: These raise HDL levels and lower triglyceride levels.
When to speak to a doctor
Before the age of 18, a doctor should check a child’s cholesterol levels at least twice. If the child’s family has a history of heart disease, overweight, or certain other health conditions, doctors may recommend checking levels more often.
A healthcare professional should check cholesterol levels in adults aged 20 or older every 4–6 years.
The doctor may recommend treatment if:
The results show high or borderline high levels of total and LDL cholesterol.
The person is overweight.
The person has a family history of heart disease.
Frequently asked questions
Here are some questions people often ask about cholesterol levels.
What is a healthy cholesterol level by age?
For children and teens, borderline high total cholesterol levels are 170–199 mg/dl and borderline high LDL levels are 100–129 mg/dl. For adults aged 20 and over, borderline high total cholesterol levels are 200–239 mg/dl and borderline high LDL levels are 130–159 mg/dl. Over this is very high.
What cholesterol level is considered high?
If total cholesterol levels are 240 mg/dl or above, a doctor will consider this very high, while 200–239 mg/dl is borderline high. Very high levels of LDL are 190 mg/dl and above. HDL cholesterol levels of 40 mg/dl or less are very low and a major risk factor for heart disease.
What reduces cholesterol quickly?
Dietary measures, weight management, and exercise can all help lower cholesterol levels. A doctor may prescribe medication if the person has other cardiovascular risk factors or if their levels are very high or do not respond to lifestyle measures.
Summary
Cholesterol levels increase with age, and having high cholesterol at any age increases the risk of a heart attack or stroke.
Reaching or maintaining healthy levels may involve lifestyle changes and, if these are not enough, prescription medication.
A doctor should check cholesterol levels in adults, starting at the age of 20, every 4–6 years.