Related Services Cardiovascular Care Heart and Vascular Aortic Aneurysm. Where Northwestern Medicine Meets Your Heart Health. Bluhm Cardiovascular Institute Center for Preventive Cardiology. Featured Experts. Micah J.

Eimer, MD. Rated 5. You Might Also Like. read more about Can You Get Heart Cancer? Who knows? It could become your next craving. Making these changes is helpful because full-fat dairy products contain saturated fat as well as cholesterol. Just as you can change what you buy in the grocery store, you can also choose healthier ways to make your food that help lower your cholesterol naturally.

For example:. When you do need to add fat for cooking, baking or pan frying, use healthy oils instead of solid fats, like butter, margarine, shortening and lard. Solid fats are high in saturated fats, but oils are high in unsaturated fats, which — remember — are better for you. The American Heart Association AHA recommends using oils that have less than 4 grams of saturated fat per tablespoon and no trans fats.

Try using olive oil, sunflower oil or grapeseed oil in place of a solid fat. You might also bring out some new, surprising, subtle flavors, too.

Plus, many vegetarian meals are just as flavorful and filling as their meaty cousins. For dessert, add some fresh blueberries, strawberries and oats to low-fat vanilla yogurt. The key here is to build up a routine, like making every Tuesday night vegetarian night. Once that becomes the norm, try expanding to different nights, or add a weekly vegetarian lunch, too.

Over time, these modifications can really pay off. This includes raising good HDL cholesterol, managing blood pressure levels and many other heart-healthy benefits. Do I need to start running every day? Do I need to join a gym or buy a bunch of home fitness equipment?

If you want to, go ahead! Ideally, you want to aim for at least 2. You can break that up however you like. You might focus on doing something every day, or you could dedicate yourself to just a few days per week. The key is to just get started. For example, do you usually take the elevator?

Take the stairs instead. Do you walk your dog every day? Go a little farther than usual or walk at a faster pace. Accessed June 28, Cooking to lower cholesterol. American Heart Association. Fekete AA, et al. Whey protein lowers blood pressure and improves endothelial function and lipid biomarkers in adults with prehypertension and mild hypertensions: Results from the chronic Whey2Go randomized controlled trial.

American Journal of Clinical Nutrition. Douglas PS. Exercise and fitness in the prevention of atherosclerotic cardiovascular disease. Accessed May 30, Hyperlipidemia adult. Rochester, Minn. Braun LT, et al. Effects of exercise on lipoproteins and hemostatic factors.

Smoke-free living: Benefits and milestones. Accessed May , Cardiovascular benefits and risks of moderate alcohol consumption.

Accessed May 31, Bonow RO, et al. Risk markers and the primary prevention of cardiovascular disease. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. Products and Services A Book: Mayo Clinic Family Health Book, 5th Edition Nutritional Supplements at Mayo Clinic Store Newsletter: Mayo Clinic Health Letter — Digital Edition.

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ART Home Top 5 lifestyle changes to reduce cholesterol. Show the heart some love! Give Today. Help us advance cardiovascular medicine.

Weight loss and exercise 30 minutes or more of moderate-intensity physical activity on most days of the week are essential components of lipid management 24 because they correlate with decreased triglyceride levels, increased HDL cholesterol levels, decreased blood pressure, and decreased risk for the development of diabetes.

For primary prevention of coronary heart disease, the NCEP ATP III 9 recommends an adequate trial of diet therapy approximately six to 12 weeks before drug therapy is initiated. In women with two or more risk factors for coronary heart disease and a year risk of 10 to 20 percent, drug therapy should be considered when the LDL cholesterol level is mg per dL or higher Figures 1 and 2.

In women with established coronary heart disease and LDL cholesterol levels at or above mg per dL, diet and drug therapy should be initiated immediately; adding drug therapy to lifestyle modifications may be considered in these women if their LDL cholesterol level is between and mg per dL 2. These data suggest that current guidelines are conservative.

In clinical practice, lipid-lowering goals can generally be achieved when lifestyle modifications are combined with appropriate pharmacotherapy. The selection of a lipid-lowering agent in an individual patient depends on the lipids targeted for altering and the degree of intervention needed.

Efficacy, side effect profile, and cost also should be considered. The well-established benefits of statin therapy include reduced morbidity and mortality from coronary heart disease, decreased progression of atherosclerosis and the development of fewer new lesions , regression of atherosclerotic lesions, and decreased coronary artery revascularization.

Statins also have lipid-independent effects that may account for the dramatic and early risk reductions observed in clinical trials. These beneficial effects include plaque stabilization, improvement of coronary endothelial function, inhibition of platelet thrombus formation, and anti-inflammatory activity.

The currently approved statins include atorvastatin Lipitor , fluvastatin Lescol , lovastatin Mevacor , pravastatin Pravachol , and simvastatin Zocor.

These drugs have been shown to lower LDL cholesterol levels by 22 to 60 percent. Results of four pivotal randomized, placebo-controlled trials of statin therapy 21 , 29 — 31 three in secondary prevention, one in primary prevention have shown that the benefit of statins in lowering lipid levels in women is equivalent to the benefit in men.

In these studies, the relative risk reduction for coronary heart disease ranged from 11 to 46 percent. These trials did not include enough women to provide definitive data regarding the efficacy of statins in women. However, the Heart Protection Study 26 enrolled 20, persons with established cardiovascular disease, diabetes and treated hypertension, and included a substantial number of women.

Statin therapy significantly reduced mortality, stroke, and vascular events in both men and women. The AHA and the American College of Cardiology recommend statins as first-line therapy for hyperlipidemia in women. The initial pharmacologic management of women with hypercholesterolemia should include a statin if triglyceride levels are less than mg per dL.

In women of childbearing potential and in those with mild hypercholesterolemia or intolerance to statin therapy, treatment with a bile acid sequestrant is an alternative.

If triglyceride levels are between and mg per dL 2. Niacin or a fibrate may then be added with caution to achieve a lower non—HDL cholesterol level. If triglyceride levels exceed mg per dL, they must be lowered quickly to prevent acute pancreatitis.

This can be achieved using a fibrate or niacin, with subsequent attention given to lowering the LDL cholesterol level.

Bile acid sequestrants resins and niacin exert significant LDL cholesterol—lowering effects, although the benefits are less than those observed with statins.

Colesevelam Welchol , a newly available resin, reportedly has fewer gastrointestinal side effects than previous bile acid sequestrants.

Because it does not have the triglyceride-raising effect of traditional resins and is not systemically absorbed, it may be a good option in women especially among those of childbearing age.

Fibrates e. One recent study 33 in men with coronary heart disease and normal LDL cholesterol levels showed that gemfibrozil raised HDL cholesterol levels, lowered triglyceride levels, and reduced mortality by 22 percent.

The value of fibrates in women whose primary lipid abnormality is a low HDL cholesterol level remains to be established. Treatment with combined statins and fibrates may increase the risk of myositis and rhabdomyolysis. The use of niacin is limited by its poor tolerability and the fact that it may worsen glucose intolerance.

Newer formulations, such as an extended-release form Niaspan , may be better tolerated. Estrogen replacement using unopposed conjugated equine estrogens has been shown to decrease LDL cholesterol and lipoprotein a levels and to increase HDL cholesterol, HDL 2 , and apolipoprotein A-I levels.

No overall reduction in the risk of nonfatal myocardial infarction or coronary heart disease mortality was found after 4. Hormone replacement therapy was also associated with an increased incidence of thromboembolic events and gallbladder disease. An angiographic study 37 of women with coronary heart disease showed that conjugated equine estrogens alone or in combination with medroxyprogesterone acetate did not reduce the progression of coronary heart disease after three years.

On the basis of these and other findings, the initiation or continuation of hormone replacement therapy for the sole purpose of secondary prevention of coronary heart disease is not recommended.

The ongoing Women's Health Initiative should provide more definitive recommendations on the role of hormone replacement therapy in the primary prevention of coronary heart disease.

Optimal management of lipids is an important component of a comprehensive cardiovascular disease prevention program. Suggested checklists to use in evaluating preventive interventions in women with and without coronary heart disease, based on consensus recommendations for coronary heart disease risk factor management, are presented in Figures 3 14 and 4.

American Heart Association. Dallas: American Heart Association, Mosca L, Jones WK, King KB, Ouyang P, Redberg RF, Hill MN.

Awareness, perception, and knowledge of heart disease risk and prevention among women in the United States. American Heart Association Women's Heart Disease and Stroke Campaign Task Force. Arch Fam Med. Bickell NA, Pieper KS, Lee KL, Mark DB, Glower DD, Pryor DB, et al. Referral patterns for coronary artery disease treatment: gender bias or good clinical judgment?.

Ann Intern Med. Shaw LJ, Miller DD, Romeis JC, Kargl D, Younis LT, Chaitman BR. Gender differences in the non-invasive evaluation and management of patients with suspected coronary artery disease. Steingart RM, Packer M, Hamm P, Coglianese ME, Gersh B, Geltman EM, et al.

Sex differences in the management of coronary artery disease. Survival and Ventricular Enlargement Investigators. N Engl J Med. Vaccarino V, Parsons L, Every NR, Barron HV, Krumholz HM. Sex-based differences in early mortality after myocardial infarction.

National Registry of Myocardial Infarction 2 Participants. Mosca L, Manson JE, Sutherland SE, Langer RD, Manolio T, Barrett-Connor E. Cardiovascular disease in women: a statement for healthcare professionals from the American Heart Association. Writing Group. Summary of the second report of the National Cholesterol Education Program NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Adult Treatment Panel II.

Executive summary of the third report of the National Cholesterol Education Program NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Adult Treatment Panel III.. Manolio TA, Pearson TA, Wenger NK, Barrett-Connor E, Payne GH, Harlan WR. Cholesterol and heart disease in older persons and women.

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Prevention of myocardial infarction. New York: Oxford University Press,— Willett WC, Green A, Stampfer MJ, Speizer FE, Colditz GA, Rosner B, et al.

Relative and absolute excess risks of coronary heart disease among women who smoke cigarettes. Mosca L, Grundy SM, Judelson D, King K, Limacher M, Oparil S, et al. Guide to preventive cardiology for women. Hoerger TJ, Bala MV, Bray JW, Wilcosky TC, LaRosa J. Treatment patterns and distribution of low-density lipoprotein cholesterol levels in treatment-eligible United States adults.

Am J Cardiol. Pearson TA, Laurora I, Chu H, Kafonek S. The Lipid Treatment Assessment Project L-TAP : a multicenter survey to evaluate the percentages of dyslipidemic patients receiving lipid-lowering therapy and achieving low-density lipoprotein cholesterol goals. Arch Intern Med.

Guidelines for using serum cholesterol, high-density lipoprotein cholesterol, and triglyceride levels as screening tests for preventing coronary heart disease in adults. American College of Physicians.

Part 1. Screening for high blood cholesterol and other lipid abnormalities. In: Guide to clinical preventive services: a report of the U.

Preventive Services Task Force. Prevention of coronary heart disease in clinical practice. Recommendations of the Second Joint Task Force of European and Other Societies on Coronary Prevention. Eur Heart J. Downs JR, Clearfield M, Weis S, Whitney E, Shapiro DR, Beere PA, et al.

Gotto AM Jr. The ILIB lipid handbook for clinical practice: blood lipids and coronary heart disease. New York: International Lipid Information Bureau, ,53, Yeshurun D, Gotto AM. Hyperlipidemia: perspectives in diagnosis and treatment.

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In a study , researchers found evidence that even performing less than the recommended minutes may increase heart-healthy HDL cholesterol more than not exercising at all.

Learn more about exercises for lowering cholesterol. Quitting smoking can benefit many aspects of your health, including lowering your cholesterol. In a study , researchers found that people who smoked had a:. Quitting smoking can greatly decrease your risk of cardiovascular disease, but heavy smokers may still be at an elevated risk 5 years after quitting.

Learn more about quitting smoking. Low to moderate levels of alcohol consumption are associated with better cardiovascular health, whereas heavy drinking is associated with poorer health. The CDC defines moderate drinking as one drink or less a day for women and two drinks or less a day for men.

In a study , researchers found that compared with non-heavy drinkers, people who drink heavily are more likely to smoke tobacco, have high blood pressure, and have elevated:.

The researchers also found that among people who drank alcohol, those who drank wine exclusively had better cardiovascular health than those who drank beer exclusively.

Learn more about the connection between alcohol and cholesterol. Here are some dietary changes you can make to help manage your cholesterol levels. The AHA recommends minimizing saturated and trans fats. These fats are associated with increases in LDL cholesterol. To lower your intake of these fats, the AHA recommends emphasizing a diet high in:.

Studies have shown that vegetarian diets, like the Portfolio Diet , can effectively lower cholesterol. The current Dietary Guidelines for Americans suggest that you can replace proteins from high fat meats with protein from plants.

The AHA suggests that a plant-based diet could help reduce your cholesterol without using medications. Learn more about diets for heart health. Food cooked at restaurants often contains higher levels of saturated fat and sugar than meals you prepare at home.

There are still several unknowns about the role of sugar on cholesterol levels, but some research suggests diets high in processed sugar are linked to poorer cholesterol levels. For instance, a study found evidence that substituting the sugars fructose and sucrose for starchy carbs was associated with lower LDL.

The AHA recommends a diet emphasizing fish and poultry and limiting red meats to limit saturated fats. When you do eat meat, here are ways you can lower the saturated fat content:. The AHA has a database of heart-healthy recipes to make cooking healthy easy.

In a study , researchers found that people who had overweight and added one avocado per day to their diet had modest but significant reductions in total and LDL cholesterol. Learn more about avocados and cholesterol.

Studies suggest that soluble fibers can help lower LDL cholesterol levels. Foods high in soluble fiber include:. Learn more about the connection between fiber and cholesterol.

Many of the above lifestyle and dietary changes directly contribute to losing weight. Learn more about medications used to treat high cholesterol.

Statins are the most prescribed cholesterol medications. They work by decreasing cholesterol production in your liver. Statins are generally very effective at reducing LDL cholesterol and lowering your risk of heart attack and stroke.

A doctor may also recommend non-statin medications such as:. Some types of supplements may help lower cholesterol levels. Psyllium is a type of fiber made from husks of Plantago ovata seeds.

Learn more about psyllium. Fish oil contains omega-3 fatty acids that are linked to increased cardiovascular health. According to the AHA , fish also lowers your triglyceride levels and reduced your risk of heart attack and stroke. Learn more about fish oil for cholesterol.

Coenzyme Q10 CoQ10 is an antioxidant produced in your body and is found in many foods. A review found that CoQ10 supplementation may decrease total cholesterol and increase HDL cholesterol. Learn more about coenzyme Q Plant sterols are waxes from plants that may help reduce the amount of cholesterol absorbed in your body.

Reviews of studies show that 1. Learn more about plant sterols. Niacin is also called vitamin B3. Learn more about the benefits of niacin. Fenugreek is an herb common in Indian dishes. In a review , researchers found that fenugreek may significantly improve cholesterol levels, but more high quality studies are needed to confirm its benefits.

Learn more about fenugreek. Here are some questions that you may want to ask a doctor:. You can lower your cholesterol levels with a combination of lifestyle habits and, if needed, medications. Some habits that may lower your cholesterol include:. Some studies show that eating less processed sugar may also help to reduce your cholesterol levels.

These medications can be effective but can also cause side effects. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. There are two types of cholesterol: LDL and HDL. Having too much LDL cholesterol can put you at greater risk of heart attack or stroke.

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