Cholesterol levels vary by age, weight, and sex. The body produces more cholesterol over time, so doctors recommend that everyone 20 years and older check their cholesterol levels regularly, ideally about every 5 years.
The Centers for Disease Control and Prevention (CDC) estimate 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 explain how doctors measure cholesterol, and we describe the healthy levels at different stages of life. We also look at ways of lowering cholesterol and maintaining healthy levels.
Cholesterol is a waxy, fat-like substance, and 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 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 every 5 years, or more frequently if they have other cardiovascular disease risk factors.
Children are less likely to have high cholesterol, and doctors may only need to check their levels twice before they turn 18 years old.
However, kids with risk factors for high cholesterol should have their levels checked more frequently.
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).
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.
Total cholesterol
Total cholesterol levels under 200 mg/dl are healthy for adults.
Doctors treat readings of 200–239 mg/dl as borderline high, and readings of at least 240 mg/dl as high.
LDL cholesterol
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.
If a person’s reading is 130–159 mg/dl, it is borderline high, while readings of 160–189 mg/dl are high. A reading of at least 190 mg/dl is very high.
HDL cholesterol
Doctors recommend keeping HDL levels higher. People with a reading of less than 40 mg/dl may have a risk of heart disease.
If a person’s reading is 41–59 mg/dl, doctors consider this borderline low. Optimal HDL levels are 60 mg/dl or higher.
Cholesterol levels for children
According to the American Academy of Pediatrics, children should have total cholesterol readings of under 170 mg/dl.
The borderline high range is 170–199 mg/dl, and a reading of 200 mg/dl or over is high.
LDL cholesterol levels should be under 110 mg/dl. The borderline high range is 110–129 mg/dl, and any reading over 130 mg/dl is high.
Other factors that affect blood cholesterol
The CDC 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.
The NIH recommends these strategies for lowering cholesterol levels:
- having a diet rich in heart-healthy 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, but overall, it advises a person to get at least 30 minutes of exercise a day.
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: These drugs keep the liver from producing 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.
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.
Cholesterol levels increase with age, and having high cholesterol at any age increases the risk of heart attacks and strokes.
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.