triglycerides

What are triglycerides?

Triglycerides are a type of fat. They are the most common type of fat in your body. They come from foods, especially butter, oils, and other fats you eat. Triglycerides also come from extra calories. These are the calories that you eat, but your body does not need right away. Your body changes these extra calories into triglycerides and stores them in fat cells. When your body needs energy, it releases the triglycerides. Your VLDL cholesterol particles carry the triglycerides to your tissues.

Having a high level of triglycerides can raise your risk of heart diseases, such as coronary artery disease.

What causes high triglycerides?

Factors that can raise your triglyceride level include:

• Regularly eating more calories than you burn off, especially if you eat a lot of sugar
• Being overweight or having obesity
• Cigarette smoking
• Excessive alcohol use
• Certain medicines
• Some genetic disorders
• Thyroid diseases
• Poorly controlled type 2 diabetes
• Liver or kidney diseases

How are high triglycerides diagnosed?

There is a blood test that measures your triglycerides, along with your cholesterol. Triglyceride levels are measured in milligrams per deciliter (mg/dL). The guidelines for triglyceride levels are

CategoryTriglyceride LevelNormalLess than 150mg/dLBorderline high150 to 199 mg/dLHigh200 to 499 mg/dLVery high500 mg/dL and above

Levels above 150mg/dl may raise your risk for heart disease. A triglyceride level of 150 mg/dL or higher is also a risk factor for metabolic syndrome.

What are the treatments for high triglycerides?

You may be able to lower your triglyceride levels with lifestyle changes:

• Controlling your weight
• Regular physical activity
• Not smoking
• Limiting sugar and refined foods
• Limiting alcohol
• Switching from saturated fats to healthier fats

Some people will also need to take cholesterol medicines to lower their triglycerides.

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.

What is VLDL cholesterol?

VLDL stands for very-low-density lipoprotein. Your liver makes VLDL and releases it into your bloodstream. The VLDL particles mainly carry triglycerides, another type of fat, to your tissues. VLDL is similar to LDL cholesterol, but LDL mainly carries cholesterol to your tissues instead of triglycerides.

VLDL and LDL are sometimes called "bad" cholesterols because they can contribute to the buildup of plaque in your arteries. This buildup is called atherosclerosis. The plaque that builds up is a sticky substance made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, the plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your body. It can lead to coronary artery disease and other heart diseases.

How do I know what my VLDL level is?

There isn't a way to directly measure your VLDL level. Instead, you will most likely get a blood test to measure your triglyceride level. The lab can use your triglyceride level to estimate what your VLDL level is. Your VLDL is about one-fifth of your triglyceride level. However, estimating your VLDL this way does not work if your triglyceride level is very high.

What should my VLDL level be?

Your VLDL level should be less than 30 mg/dL (milligrams per deciliter). Anything higher than that puts you at risk for heart disease and stroke.

How can I lower my VLDL level?

Since VLDL and triglycerides are linked, you can lower VLDL level by lowering your triglyceride level. You may be able to lower your triglycerides with a combination of losing weight, diet, and exercise. It is important to switch to healthy fats, and cut back on sugar and alcohol. Some people may also need to take medicines.

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But if you have too much cholesterol in your blood, you have a higher risk of coronary artery disease.

How do you measure cholesterol levels?

A blood test called a lipoprotein panel can measure your cholesterol levels. Before the test, you'll need to fast (not eat or drink anything but water) for 9 to 12 hours. The test gives information about your:

• Total cholesterol - a measure of the total amount of cholesterol in your blood. It includes both low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.
• LDL (bad) cholesterol - the main source of cholesterol buildup and blockage in the arteries
• HDL (good) cholesterol - HDL helps remove cholesterol from your arteries
• Non-HDL - this number is your total cholesterol minus your HDL. Your non-HDL includes LDL and other types of cholesterol such as VLDL (very-low-density lipoprotein).
• Triglycerides - another form of fat in your blood that can raise your risk for heart disease, especially in women

What do my cholesterol numbers mean?

Cholesterol numbers are measured in milligrams per deciliter (mg/dL). Here are the healthy levels of cholesterol, based on your age and gender:

Anyone age 19 or younger:

Type of CholesterolHealthy LevelTotal CholesterolLess than 170mg/dLNon-HDLLess than 120mg/dLLDLLess than 100mg/dLHDLMore than 45mg/dL

Men age 20 or older:

Type of CholesterolHealthy LevelTotal Cholesterol125 to 200mg/dLNon-HDLLess than 130mg/dLLDLLess than 100mg/dLHDL40mg/dL or higher

Women age 20 or older:

Type of CholesterolHealthy LevelTotal Cholesterol125 to 200mg/dLNon-HDLLess than 130mg/dLLDLLess than 100mg/dLHDL50mg/dL or higher

Triglycerides are not a type of cholesterol, but they are part of a lipoprotein panel (the test that measures cholesterol levels). A normal triglyceride level is below 150 mg/dL. You might need treatment if you have triglyceride levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more).

How often should I get a cholesterol test?

When and how often you should get a cholesterol test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger:

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older:

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

What affects my cholesterol levels?

A variety of things can affect cholesterol levels. These are some things you can do to lower your cholesterol levels:

• Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise. Saturated fat is the main problem, but cholesterol in foods also matters. Reducing the amount of saturated fat in your diet helps lower your blood cholesterol level. Foods that have high levels of saturated fats include some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.
• Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL (bad) cholesterol, total cholesterol, and triglyceride levels. It also raises your HDL (good) cholesterol level.
• Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.
• Smoking.Cigarette smoking lowers your HDL (good) cholesterol. HDL helps to remove bad cholesterol from your arteries. So a lower HDL can contribute to a higher level of bad cholesterol.

Things outside of your control that can also affect cholesterol levels include:

• Age and Sex. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women's LDL (bad) cholesterol levels tend to rise.
• Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
• Race. Certain races may have an increased risk of high blood cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.

How can I lower my cholesterol?

There are two main ways to lower your cholesterol:

• Heart-healthy lifestyle changes, which include:
• Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated and trans fats that you eat. Examples include the Therapeutic Lifestyle Changes diet and the DASH Eating Plan.
• Weight Management. If you are overweight, losing weight can help lower your LDL (bad) cholesterol.
• Physical Activity. Everyone should get regular physical activity (30 minutes on most, if not all, days).
• Managing stress. Research has shown that chronic stress can sometimes raise your LDL cholesterol and lower your HDL cholesterol.
• Quitting smoking.Quitting smoking can raise your HDL cholesterol. Since HDL helps to remove LDL cholesterol from your arteries, having more HDL can help to lower your LDL cholesterol.
• Drug Treatment. If lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol medicines available, including statins. The medicines work in different ways and can have different side effects. Talk to your health care provider about which one is right for you. While you are taking medicines to lower your cholesterol, you should continue with the lifestyle changes.

NIH: National Heart, Lung, and Blood Institute

Heart disease is the leading cause of the death in the United States. It is also a major cause of disability. There are many things that can raise your risk for heart disease. They are called risk factors. Some of them you cannot control, but there are many that you can control. Learning about them can lower your risk of heart disease.

What are the heart disease risk factors that I cannot change?

• Age. Your risk of heart disease increases as you get older. Men age 45 and older and women age 55 and older have a greater risk.
• Sex. Some risk factors may affect heart disease risk differently in women than in men. For example, estrogen provides women some protection against heart disease, but diabetes raises the risk of heart disease more in women than in men.
• Race or ethnicity. Certain groups have higher risks than others. African Americans are more likely than whites to have heart disease, while Hispanic Americans are less likely to have it. Some Asian groups, such as East Asians, have lower rates, but South Asians have higher rates.
• Family history. You have a greater risk if you have a close family member who had heart disease at an early age.

What can I do to lower my risk of heart disease?

Fortunately, there are many things you can do to reduce your chances of getting heart disease:

• Control your blood pressure.High blood pressure is a major risk factor for heart disease. It is important to get your blood pressure checked regularly - at least once a year for most adults, and more often if you have high blood pressure. Take steps, including lifestyle changes, to prevent or control high blood pressure.
• Keep your cholesterol and triglyceride levels under control. High levels of cholesterol can clog your arteries and raise your risk of coronary artery disease and heart attack. Lifestyle changes and medicines (if needed) can lower your cholesterol. Triglycerides are another type of fat in the blood. High levels of triglycerides may also raise the risk of coronary artery disease, especially in women.
• Stay at a healthy weight. Being overweight or having obesity can increase your risk for heart disease. This is mostly because they are linked to other heart disease risk factors, including high blood cholesterol and triglyceride levels, high blood pressure, and diabetes. Controlling your weight can lower these risks.
• Eat a healthy diet. Try to limit saturated fats, foods high in sodium, and added sugars. Eat plenty of fresh fruit, vegetables, and whole grains. The DASH diet is an example of an eating plan that can help you to lower your blood pressure and cholesterol, two things that can lower your risk of heart disease.
• Get regular exercise. Exercise has many benefits, including strengthening your heart and improving your circulation. It can also help you maintain a healthy weight and lower cholesterol and blood pressure. All of these can lower your risk of heart disease.
• Limit alcohol. Drinking too much alcohol can raise your blood pressure. It also adds extra calories, which may cause weight gain. Both of those raise your risk of heart disease. Men should have no more than two alcoholic drinks per day, and women should not have more than one.
• Don't smoke. Cigarette smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, do not start. If you do smoke, quitting will lower your risk for heart disease. You can talk with your health care provider for help in finding the best way for you to quit.
• Manage stress.Stress is linked to heart disease in many ways. It can raise your blood pressure. Extreme stress can be a "trigger" for a heart attack. Also, some common ways of coping with stress, such as overeating, heavy drinking, and smoking, are bad for your heart. Some ways to help manage your stress include exercise, listening to music, focusing on something calm or peaceful, and meditating.
• Manage diabetes. Having diabetes doubles your risk of diabetic heart disease. That is because over time, high blood sugar from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. So, it is important to get tested for diabetes, and if you have it, to keep it under control.
• Make sure that you get enough sleep. If you don't get enough sleep, you raise your risk of high blood pressure, obesity, and diabetes. Those three things can raise your risk for heart disease. Most adults need 7 to 9 hours of sleep per night. Make sure that you have good sleep habits. If you have frequent sleep problems, contact your health care provider. One problem, sleep apnea, causes people to briefly stop breathing many times during sleep. This interferes with your ability to get a good rest and can raise your risk of heart disease. If you think you might have it, ask your doctor about having a sleep study. And if you do have sleep apnea, make sure that you get treatment for it.

What is cholesterol?

Your body needs some cholesterol to work properly. But if you have too much in your blood, it can stick to the walls of your arteries and narrow or even block them. This puts you at risk for coronary artery disease and other heart diseases.

Cholesterol travels through the blood on proteins called lipoproteins. One type, LDL, is sometimes called the "bad" cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. Another type, HDL, is sometimes called the "good" cholesterol. It carries cholesterol from other parts of your body back to your liver. Then your liver removes the cholesterol from your body.

What are the treatments for high cholesterol?

If you have high cholesterol, lifestyle changes can help you to lower your cholesterol level. But sometimes the lifestyle changes are not enough, and you need to take cholesterol medicines. You should still continue with the lifestyle changes even though you are taking medicines.

Who needs cholesterol medicines?

Your health care provider may prescribe medicine if:

• You have already had a heart attack or stroke, or you have peripheral arterial disease
• Your LDL (bad) cholesterol level is 190 mg/dL or higher
• You are 40-75 years old, you have diabetes, and your LDL cholesterol level is 70 mg/dL or higher
• You are 40-75 years old, you have a high risk of developing heart disease or stroke, and your LDL cholesterol level is 70 mg/dL or higher

What are the different types of medicines for cholesterol?

There are several types of cholesterol-lowering drugs available, including:

• Statins, which block the liver from making cholesterol
• Bile acid sequestrants, which decrease the amount of fat absorbed from food
• Cholesterol absorption inhibitors, which decrease the amount of cholesterol absorbed from food and lower triglycerides.
• Nicotinic acid (niacin), which lowers LDL (bad) cholesterol and triglycerides and raises HDL (good) cholesterol. Even though you can buy niacin without a prescription, you should talk to your health care provider before taking it to lower your cholesterol. High doses of niacin can cause serious side effects.
• PCSK9 inhibitors, which block a protein called PCSK9. This helps your liver remove and clear LDL cholesterol from your blood.
• Fibrates, which lower triglycerides. They may also raise HDL (good) cholesterol. If you take them with statins, they may increase the risk of muscle problems.
• Combination medicines, which include more than one type of cholesterol-lowering medicine

There are also a few other cholesterol medicines (lomitapide and mipomersen) that are only for people who have familial hypercholesterolemia (FH). FH is an inherited disorder that causes high LDL cholesterol.

How does my health care provider decide which cholesterol medicine I should take?

When deciding which medicine you should take and which dose you need, your health care provider will consider:

• Your cholesterol levels
• Your risk for heart disease and stroke
• Your age
• Any other health problems you have
• Possible side effects of the medicines. Higher doses are more likely to cause side effects, especially over time.

Medicines can help control your cholesterol, but they don't cure it. You need to keep taking your medicines and get regular cholesterol checks to make sure that you cholesterol levels are in a healthy range.

What is metabolic syndrome?

Metabolic syndrome is the name for a group of risk factors for heart disease, diabetes, and other health problems. You can have just one risk factor, but people often have several of them together. When you have at least three of them, it is called metabolic syndrome. These risk factors include:

• A large waistline, also called abdominal obesity or "having an apple shape." Too much fat around the stomach is a greater risk factor for heart disease than too much fat in other parts of the body.
• Having a high triglyceride level. Triglycerides are a type of fat found in the blood.
• Having a low HDL cholesterol level. HDL is sometimes called the "good" cholesterol because it helps remove cholesterol from your arteries.
• Having high blood pressure. If your blood pressure stays high over time, it can damage your heart and lead to other health problems.
• Having a high fasting blood sugar. Mildly high blood sugar may be an early sign of diabetes.

The more factors you have, the higher your risk for heart disease, diabetes, and stroke is.

What causes metabolic syndrome?

Metabolic syndrome has several causes that act together:

• Overweight and obesity
• An inactive lifestyle
• Insulin resistance, a condition in which the body can't use insulin properly. Insulin is a hormone that helps move blood sugar into your cells to give them energy. Insulin resistance can lead to high blood sugar levels.
• Age - your risk goes up as get older
• Genetics - ethnicity and family history

People who have metabolic syndrome often also have excessive blood clotting and inflammation throughout the body. Researchers don't know whether these conditions cause metabolic syndrome or worsen it.

Who is at risk for metabolic syndrome?

The most important risk factors for metabolic syndrome are:

• Abdominal obesity (a large waistline)
• An inactive lifestyle
• Insulin resistance

There are certain groups of people who have an increased risk of metabolic syndrome:

• Some racial and ethnic groups. Mexican Americans have the highest rate of metabolic syndrome, followed by whites and blacks.
• People who have diabetes
• People who have a sibling or parent who has diabetes
• Women with polycystic ovary syndrome (PCOS)
• People who take medicines that cause weight gain or changes in blood pressure, blood cholesterol, and blood sugar levels

What are the symptoms of metabolic syndrome?

Most of the metabolic risk factors have no obvious signs or symptoms, except for a large waistline.

How is metabolic syndrome diagnosed?

Your health care provider will diagnose metabolic syndrome based on the results of a physical exam and blood tests. You must have at least three of the risk factors to be diagnosed with metabolic syndrome:

• A large waistline, which means a waist measurement of
  • 35 inches or more for women
  • 40 inches or more for men
• A high triglyceride level, which is 150 mg/dL or higher
• A low HDL cholesterol level, which is
  • Less than 50 mg/dL for women
  • Less than 40 mg/dL for men
• High blood pressure, which is a reading of 130/85 mmHg or higher.
• A high fasting blood sugar, which is 100 mg/dL or higher

What are the treatments for metabolic syndrome?

The most important treatment for metabolic syndrome is a heart-healthy lifestyle, which includes:

• A heart-healthy eating plan, which limits the amount of saturated and trans fats that you eat. It encourages you to choose a variety of nutritious foods, including fruits, vegetables, whole grains, and lean meats.
• Aiming for a healthy weight
• Managing stress
• Getting regular physical activity
• Quitting smoking (or not starting if you don't already smoke)

If making lifestyle changes is not enough, you may need to take medicines. For example, you may need medicines to lower cholesterol or blood pressure.

Can metabolic syndrome be prevented?

The best way to prevent metabolic syndrome is through the heart-healthy lifestyle changes.

NIH: National Heart, Lung, and Blood Institute

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood sugar levels.

What is diabetic heart disease?

Diabetic heart disease is a term for heart disease in people who have diabetes. If you have diabetes, you are much more likely to develop heart disease or have a stroke than people who don't have diabetes. And you may start having these problems at a younger age.

Over time, the effects of high blood sugar from diabetes can include damage to the blood vessels and nerves in your heart. This damage increases your chance of developing heart diseases, including:

• Coronary artery disease (CAD). It happens slowly as a sticky material called plaque builds up in the arteries that supply your heart muscle with blood.
• Heart failure. With this condition, your heart can't pump enough oxygen-rich blood to meet the needs of your body.
• Cardiomyopathy. This is a group of diseases in which the heart muscle may become thick or stiff.

Who is more likely to develop diabetic heart disease?

Diabetes puts you at serious risk for heart disease. It also makes you more likely to develop other conditions that raise your risk even more, including:

• High blood pressure
• High blood levels of LDL "bad" cholesterol
• High triglycerides (a type of fat in your blood) with low blood levels of HDL "good" cholesterol

Your risk for heart disease is also higher if you

• Are male
• Smoke
• Have obesity
• Have too much belly fat around your waist, even though you're at a healthy weight:
  • For men, that's a waist more than 40 inches
  • For women, that's a waist more than 35 inches
• Have a family history of heart disease
• Have chronic kidney disease

What are the symptoms of diabetic heart disease?

In the early stages, heart disease usually doesn't have any symptoms. But if your heart disease worsens, you can have symptoms. Your symptoms will depend on the type of heart disease you have. They might include:

• Shortness of breath
• Fatigue
• Dizziness or fainting
• Arrhythmia (problem with the rate or rhythm of your heartbeat)
• Swollen feet and ankles
• Chest pain

It's important to know that people with diabetes may not feel chest pain. That's because diabetes can damage the nerves in your heart. If you have any symptoms that could be heart disease, talk with your health care provider.

How is diabetic heart disease diagnosed?

To find out if you have diabetic heart disease, your provider will:

• Ask about your medical history, including your symptoms and other health conditions you may have
• Ask about your family history, to find out if you have relatives who have or had heart disease
• Do a physical exam
• Likely run some tests to help understand your personal risk for heart disease, including:
  • Blood tests to check your cholesterol, triglycerides, and blood sugar levels
  • A blood-pressure check
  • Heart tests, if needed

Depending on your risk level, your provider may send you to a cardiologist (a doctor who specializes in heart diseases) for care. If you do have heart disease, treatment will depend on the type of heart disease you have.

How can I prevent diabetic heart disease?

You may be able to prevent heart disease or keep it from getting worse by working with your provider to:

• Control your blood sugar levels
• Manage other conditions you may have that can raise your risk for heart disease
• Take any medicines your provider prescribed
• Make heart-healthy habits part of your daily life
• Follow a healthy eating plan for diabetes

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

We have all heard it many times before - regular exercise is good for you, and it can help you lose weight. But if you are like many Americans, you are busy, you have a sedentary job, and you haven't yet changed your exercise habits. The good news is that it's never too late to start. You can start slowly, and find ways to fit more physical activity into your life. To get the most benefit, you should try to get the recommended amount of exercise for your age. If you can do it, the payoff is that you will feel better, help prevent or control many diseases, and likely even live longer.

What are the health benefits of exercise?

Regular exercise and physical activity may:

• Help you control your weight. Along with diet, exercise plays an important role in controlling your weight and preventing obesity. To maintain your weight, the calories you eat and drink must equal the energy you burn. To lose weight, you must use more calories than you eat and drink.
• Reduce your risk of heart diseases. Exercise strengthens your heart and improves your circulation. The increased blood flow raises the oxygen levels in your body. This helps lower your risk of heart diseases such as high cholesterol, coronary artery disease, and heart attack. Regular exercise can also lower your blood pressure and triglyceride levels.
• Help your body manage blood sugar and insulin levels. Exercise can lower your blood sugar level and help your insulin work better. This can cut down your risk for metabolic syndrome and type 2 diabetes. And if you already have one of those diseases, exercise can help you to manage it.
• Help you quit smoking. Exercise may make it easier to quit smoking by reducing your cravings and withdrawal symptoms. It can also help limit the weight you might gain when you stop smoking.
• Improve your mental health and mood. During exercise, your body releases chemicals that can improve your mood and make you feel more relaxed. This can help you deal with stress and reduce your risk of depression.
• Help keep your thinking, learning, and judgment skills sharp as you age. Exercise stimulates your body to release proteins and other chemicals that improve the structure and function of your brain.
• Strengthen your bones and muscles. Regular exercise can help kids and teens build strong bones. Later in life, it can also slow the loss of bone density that comes with age. Doing muscle-strengthening activities can help you increase or maintain your muscle mass and strength.
• Reduce your risk of some cancers, including colon, breast , uterine, and lung cancer.
• Reduce your risk of falls. For older adults, research shows that doing balance and muscle-strengthening activities in addition to moderate-intensity aerobic activity can help reduce your risk of falling.
• Improve your sleep. Exercise can help you to fall asleep faster and stay asleep longer.
• Improve your sexual health. Regular exercise may lower the risk of erectile dysfunction (ED) in men. For those who already have ED, exercise may help improve their sexual function. In women, exercise may increase sexual arousal.
• Increase your chances of living longer. Studies show that physical activity can reduce your risk of dying early from the leading causes of death, like heart disease and some cancers.

How can I make exercise a part of my regular routine?

• Make everyday activities more active. Even small changes can help. You can take the stairs instead of the elevator. Walk down the hall to a coworker's office instead of sending an email. Wash the car yourself. Park further away from your destination.
• Be active with friends and family. Having a workout partner may make you more likely to enjoy exercise. You can also plan social activities that involve exercise. You might also consider joining an exercise group or class, such as a dance class, hiking club, or volleyball team.
• Keep track of your progress. Keeping a log of your activity or using a fitness tracker may help you set goals and stay motivated.
• Make exercise more fun. Try listening to music or watching TV while you exercise. Also, mix things up a little bit - if you stick with just one type of exercise, you might get bored. Try doing a combination of activities.
• Find activities that you can do even when the weather is bad. You can walk in a mall, climb stairs, or work out in a gym even if the weather stops you from exercising outside.

What is high blood pressure?

High blood pressure, also called hypertension, is when blood puts too much pressure against the walls of your arteries. Almost half of American adults have high blood pressure, usually with no symptoms. But it can cause serious problems such as stroke, heart failure, heart attack, and kidney disease.

What lifestyle changes can help lower high blood pressure?

Healthy lifestyle changes can help reduce high blood pressure:

• Losing weight
• Being physically active
• Managing stress
• Reducing sodium in your diet
• Avoiding alcohol, tobacco, and illegal drugs
• Getting enough sleep

What if lifestyle changes alone cannot lower blood pressure?

Sometimes lifestyle changes alone cannot control or lower your high blood pressure. In that case, your health care provider may prescribe blood pressure medicines.

How do blood pressure medicines work?

The most commonly used blood pressure medicines work in different ways to lower blood pressure:

• Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) keep your blood vessels from narrowing as much and allows blood to move through them with less pressure.
• Beta blockers help your heart beat slower and with less force. This means that your heart pumps less blood through your blood vessels. Beta blockers are typically used only as a backup option or if you also have certain other conditions.
• Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels. This allows the blood vessels to relax.
• Diuretics remove extra water and sodium (salt) from your body. This lowers the amount of fluid in your blood. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill.

Often, two or more medicines work better than one. If these medicines do not lower your blood pressure enough, your provider may suggest that you take another type of blood pressure medicine.

While taking the medicines, it is still important to keep up with your healthy lifestyle changes. Doing both helps keep blood pressure lower than lifestyle changes or medicines alone.

NIH: National Heart, Lung, and Blood Institute

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs. Cholesterol is also found in foods from animal sources, such as egg yolks, meat, and cheese.

If you have too much cholesterol in your blood, it can combine with other substances in the blood to form plaque. Plaque sticks to the walls of your arteries. This buildup of plaque is known as atherosclerosis. It can lead to coronary artery disease, where your coronary arteries become narrow or even blocked.

What are HDL, LDL, and VLDL?

HDL, LDL, and VLDL are lipoproteins. They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. Different types of lipoproteins have different purposes:

• HDL stands for high-density lipoprotein. It is sometimes called "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
• LDL stands for low-density lipoprotein. It is sometimes called "bad" cholesterol because a high LDL level leads to the buildup of plaque in your arteries.
• VLDL stands for very low-density lipoprotein. Some people also call VLDL a "bad" cholesterol because it too contributes to the buildup of plaque in your arteries. But VLDL and LDL are different; VLDL mainly carries triglycerides and LDL mainly carries cholesterol.

What causes high cholesterol?

The most common cause of high cholesterol is an unhealthy lifestyle. This can include:

• Unhealthy eating habits, such as eating lots of bad fats. One type, saturated fat, is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods. Another type, trans fat, is in some fried and processed foods. Eating these fats can raise your LDL (bad) cholesterol.
• Lack of physical activity, with lots of sitting and little exercise. This lowers your HDL (good) cholesterol.
• Smoking, which lowers HDL cholesterol, especially in women. It also raises your LDL cholesterol.

Genetics may also cause people to have high cholesterol. For example, familial hypercholesterolemia (FH) is an inherited form of high cholesterol. Other medical conditions and certain medicines may also cause high cholesterol.

What can raise my risk of high cholesterol?

A variety of things can raise your risk for high cholesterol:

• Age. Your cholesterol levels tend to rise as you get older. Even though it is less common, younger people, including children and teens, can also have high cholesterol.
• Heredity. High blood cholesterol can run in families.
• Weight. Being overweight or having obesity raises your cholesterol level.
• Race. Certain races may have an increased risk of high cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.

What health problems can high cholesterol cause?

If you have large deposits of plaque in your arteries, an area of plaque can rupture (break open). This can cause a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block blood flow in a coronary artery.

If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, it can cause angina (chest pain) or a heart attack.

Plaque also can build up in other arteries in your body, including the arteries that bring oxygen-rich blood to your brain and limbs. This can lead to problems such as carotid artery disease, stroke, and peripheral arterial disease.

How is high cholesterol diagnosed?

There are usually no signs or symptoms that you have high cholesterol. There is a blood test to measure your cholesterol level. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger::

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older::

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

How can I lower my cholesterol?

You can lower your cholesterol through heart-healthy lifestyle changes. They include a heart-healthy eating plan, weight management, and regular physical activity.

If the lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol-lowering drugs available, including statins. If you take medicines to lower your cholesterol, you still should continue with the lifestyle changes.

Some people with familial hypercholesterolemia (FH) may receive a treatment called lipoprotein apheresis. This treatment uses a filtering machine to remove LDL cholesterol from the blood. Then the machine returns the rest of the blood back to the person.

NIH: National Heart, Lung, and Blood Institute