What Causes High or "Bad" LDL Cholesterol?


Controlling your cholesterol is an important aspect of health care, as it can tell you a lot about your health. However, there are several types of cholesterol: high-density lipoprotein (HDL) or "good" cholesterol, low-density lipoprotein (LDL) , which are often considered "bad" cholesterol, and a third type, triglycerides.

Why is higher LDL cholesterol considered unhealthy and dangerous? LDL promotes the accumulation of a waxy, fat-like substance in the arteries. In turn, this can lead to atherosclerosis (hardening of the arteries), which can lead to coronary artery disease (CAD) , heart attack, and stroke , among other serious health problems.

Many factors can cause LDL levels to rise. These include genetic factors (a family history of high LDL cholesterol), obesity or being overweight, lack of exercise, diet, and medications you are taking. It is important to understand these causes as they can help you prevent and control cholesterol problems.

Get Medication Information / Brianna Gilmartin

What is high LDL?

Cholesterol itself is a necessary substance in the body. It is produced in the liver and can be found in some foods, especially meat, eggs, and dairy products. LDL is a lipoprotein, a substance that carries cholesterol into cells, helps maintain cell structure, and serves as a precursor for substances vital to human function. We all have some amount of this lipoprotein, but when it increases, problems arise.

With too much LDL, plaque builds up in the arteries, causing atherosclerosis and decreasing blood flow. When the arteries of the heart are affected, insufficient oxygen levels damage the heart muscles and cause coronary artery disease, angina (chest pain), and even a heart attack. Also, arteries in other parts of the body can be affected, which can lead to peripheral arterial disease (PAD) and stroke.

LDL measurement

Given its relationship to these conditions, it is very important to measure LDL cholesterol. How to do it? This basically includes a blood test called a lipid profile, which measures HDL and triglyceride levels along with LDL, and also calculates your total cholesterol. Special attention is paid to LDL levels, although they are all important.

A lipid profile is a blood test that only requires a small sample, usually taken from an artery or vein in the arm. For an accurate LDL reading, you may need to fast 9 to 12 hours before ingestion, avoiding certain beverages and all foods.

Healthy LDL

So what exactly are healthy LDL levels? It is measured in milligrams (mg) (LDL) per deciliter (dl) of blood. The results can be divided into four categories: optimal, near optimal, high limit, and high / very high, and these ranges are age dependent. Here's a quick breakdown:

  • Optimal: If you are between the ages of 2 and 19, doctors want to see a reading below 110 mg / dL. In older people, doctors want to see less than 100 mg / dL. In particular, if you have coronary artery disease, PAD, or other heart problems, this rate should be less than 70 mg / dL.
  • Near Optimal: For adults over the age of 20, 100 mg / dL to 129 mg / dL rates near optimal and is generally not a major concern.
  • Frontier: For children and young people under the age of 19, values from 110 mg / dL to 129 mg / dL are considered borderline, which means they are on the edge of dangerous territory. For the elderly, this range is 130 mg / dL to 159 mg / dL.
  • High / Very High: People under the age of 20 with 130 mg / dL are considered to have high levels of LDL cholesterol. In adults older than 20 years, 160 to 189 mg / dL is considered "high" and values above 190 mg / dL are "very high." The high levels are, of course, concerning.


If you have high or borderline LDL cholesterol levels, your doctor will tell you what you can do to lower your levels. One of the most important ways to combat this disease is through significant lifestyle changes.


What you eat can have a profound effect on your LDL levels. The main determinant of these levels is saturated fat, which according to the American Heart Association should represent 5% to 6% of your daily calories. In general, you should avoid foods high in this fat, which include:

  • Butter and cream
  • Beef and beef tallow
  • Lamb and pork
  • Chicken skin
  • Butter and fatty dairy products, including fatty cheeses
  • Palm oil

So what types of foods can help control LDL levels? Here's a breakdown:

  • Lean Proteins: Choose leaner protein sources, such as fish, chicken (skinless), and nuts and beans, rather than fatty meats. Skim or skim milk is also recommended.
  • Low-fat foods : Low-fat or low-fat foods like fresh vegetables and fruits, whole-grain breads, yogurts, and cheeses are low in unhealthy saturated and trans fats.
  • No added sugar: Avoid foods with added sugar. You can even find plenty of instant or frozen foods, even if they're unsweetened, with added sugar or corn syrup, so keep an eye on food labels.  
  • Fiber: Foods high in fiber are another important component of a diet to lower LDL. This means, among others, leafy vegetables, oats, beans, and apples.
  • Unsaturated Fats : Unsaturated fats are more easily absorbed by the body and, unlike saturated or trans fats, can help lower LDL levels while increasing HDL (a good type of cholesterol). Avocados, walnuts, and olive oil are rich in unsaturated fats.


Another major risk factor for high LDL cholesterol is being overweight. Being overweight or clinically obese limits your body's ability to remove this type of cholesterol from the bloodstream and is directly related to higher levels.

How are these weighted states determined? The standard metric is the body mass index (BMI), which compares your height and weight to estimate your level of body fat. While a score below 25 is considered normal or underweight, you are overweight if your score is between 25 and 29.9, and you are defined as obese if your score is 30 or more.

Although BMI has limitations as a measure of health, higher scores should be handled. Studies have shown that even a small weight loss, say 5% to 10% of baseline, lowers LDL cholesterol and other risk factors for cardiovascular disease.

Lack of physical activity

To be sure, in relation to the above, insufficient physical activity can also increase LDL levels. However, the good news is that even a small increase in the amount of exercise can help tremendously. Ideally, doctors may want you to be physically active for up to 90 minutes a day; however, even 30 to 45 minutes on a regular basis can be helpful.

At a minimum, the chief surgeon recommends that adults get moderate exercise for 2.5 hours a week. This could include:

  • A bike ride
  • Quick ride
  • Trot
  • Swimming

Smoking and alcohol

Among the many negative health effects of smoking are atherosclerosis, elevated LDL cholesterol, and lower HDL cholesterol. Kicking or stopping this habit goes a long way in controlling cholesterol and also reduces the risk of heart disease and cancer. Talk to your doctor about how to help you stop .

Secondhand smoke, when you accidentally inhale tobacco from other smokers, is also dangerous and is associated with many of the same health problems. If you smoke, smoke outdoors and away from non-smokers; If you don't smoke, you can ask others not to smoke in your home or car.

Also, due to its multiple effects on the body, excessive alcohol consumption and alcoholism are associated with higher cholesterol levels. Limiting alcohol consumption or stopping alcohol completely can help control levels.

Age and gender

Your age and gender can also have a significant impact on your LDL levels. As men and women age, they generally grow older. Men tend to have higher LDL levels than women at a young age (20 to 59 years). In contrast, women consistently had higher LDL values after middle age (60 years).

In women, menopause can also affect LDL cholesterol. The risk of premenopausal high cholesterol is much lower. That is why more frequent LDL cholesterol monitoring is recommended for women during menopause.


Like many other health conditions, a family history of high cholesterol increases the risk of developing it. High levels of LDL cholesterol due to genetics, a condition called familial hypercholesterolemia (FH) , occur in every one of the 500 people. This condition is especially dangerous because it often goes unnoticed and is associated with an early heart attack, stroke, and premature death.

In these cases, the gene that codes for the LDL cholesterol receptor protein needed to remove it from the bloodstream does not work. If this gene is derived from one of the parents, which is called heterogeneous FH, about half of these proteins are inactive. In turn, homogeneous HP occurs when both parents are carriers of the defective gene.

In particular, difficult-to-treat cases of high cholesterol may require HF genetic screening. Additionally, a family member has high cholesterol levels or a family history of early heart disease may also warrant careful investigation.

Race and ethnicity

According to a growing body of research, race and ethnicity are also a factor in high cholesterol levels. While all races and ethnic groups can have high LDL levels, there are differences based on status. Here's a quick breakdown:

  • African Americans: High cholesterol levels are found in almost equal proportions between African American men and women, with 10.6% of the former and 10.3% of the latter.
  • Hispanics: Among Hispanic men, 13.1% have high cholesterol, compared to 9% of Hispanic women.
  • Non-Hispanic Asians: Asian men and women also have fairly comparable high cholesterol levels. It occurs in 11.3% of Asian men and 10.3% of Asian women.
  • Non-Hispanic Whites: White women have the highest percentage of high cholesterol; it is estimated that 14.8% have it. Among white men, this figure drops to 10.9%.


Medications that you have been prescribed can also cause your LDL cholesterol to rise. This can be especially difficult, since the list includes medications for heart disease and high blood pressure. Before prescribing any prescription, your doctor should carefully describe the risks and benefits.

So what medications increase LDL levels? There are quite a few of them:

  • Cardiovascular medications: Certain medications for heart disease and blood pressure can cause LDL cholesterol levels to rise. These include loop diuretics [Bumex (bumetanide), Edecrine (ethacrynic acid) and others], thiazide diuretics [Zaroxoline (metallozone), Lozol (indapamide) and others] and sodium glucose cotransporter 2 (SGLT2) inhibitors [p. Eg Invokana (canagliflozin) and Farksiga (dapagliflozin)].
  • Steroids: Certain types of steroids and steroid hormones that are commonly used to reduce inflammation can also raise cholesterol levels. Higher levels of LDL are associated with androgens, danocrine (danazol), anabolic steroids (a synthesized version of the male hormone, testosterone), and certain corticosteroids such as prednisone, intensol (prednisone) , and orapred (prednisolone).
  • Antiviral therapy: Medications that take viral infections such as human immunodeficiency virus (HIV) and hepatitis C can also raise LDL levels. These include protease inhibitors like Viracept (nelfinavir) and Insevec (telaprevir) and direct-acting antivirals like Harvoni (ledipasvir) and Fuzeon (enfuvirtide).
  • Immunosuppressants : Certain immunosuppressants, especially cyclosporine and tacrolimus, used to prevent infections in organ transplants, also increase LDL levels. Corticosteroids can also have anti-inflammatory and emollient effects on the immune system.
  • Other medications: Some medications that act on the brain and central nervous system (CNS) can directly affect LDL cholesterol. These include anticonvulsants used for epilepsy, Alzheimer's disease, and other conditions, such as Depakote (valproic acid) and Topamax (topiramate) .

Many medications can affect LDL cholesterol, so careful monitoring is necessary when controlling high cholesterol levels.

Other health conditions

Lastly, high cholesterol levels can also be due to other conditions, disorders, or diseases you may have. This includes:

  • Type 2 diabetes: one of the main consequences of diabetes is the inadequate production of insulin, which breaks down sugar. This limits the body's ability to process LDL.
  • Liver disease: Liver problems , such as cirrhosis of the liver, can also immediately affect cholesterol levels.
  • Kidney disease: Because the kidneys play a central role in cleaning the bloodstream, problems like chronic kidney disease also cause spikes in cholesterol levels.
  • Pregnancy: pregnant women tend to have higher cholesterol levels. The situation is generally monitored as high levels during this time increase the risk of certain complications.
  • Thyroid ProblemsHypothyroidism , an underactive thyroid gland, is known to dramatically increase LDL levels. If your level is high, you will need a thyroid test.

Frequent questions

What Makes LDL Cholesterol Too High?

Several medical and lifestyle factors cause high levels of LDL cholesterol, including:

  • Diet: A diet high in saturated fat, salt, and cholesterol (found in fatty meats, some processed foods, dairy products, and jerky) and low in healthy protein (fish, nuts, avocados, etc.) and fiber (such as, vegetables leaves and apples) can lead to high LDL levels.
  • Lack of physical activity: Lack of exercise and a sedentary lifestyle contribute to weight gain and can also increase levels. You can see higher LDL levels if you don't exercise for at least 30 minutes a day.
  • Weight status: Being overweight or obese significantly increases your chances of developing high levels of LDL cholesterol. Even a small weight gain can raise the level to unhealthy levels.
  • Alcohol and tobacco: Smoking and alcohol consumption are linked to high cholesterol levels, among many other harmful effects on health.
  • Genetics: High levels of LDL cholesterol can be inherited, a condition called familial hypercholesterolemia (FH). The severity of HF varies, but patients with the homozygous form, in which both parents carry the defective gene, can have extremely high amounts of this type of cholesterol.
  • Medications: Taking several kinds of medications can cause LDL cholesterol to rise. These include, but are not limited to, heart disease, high blood pressure, inflammation, certain viruses, and seizures. Talk to your doctor about how these prescriptions can affect your cholesterol.
  • Health Conditions: Diseases and conditions that cause high LDL cholesterol include type 2 diabetes, pregnancy, chronic kidney disease, and hypothyroidism.

What foods raise LDL cholesterol?

Your diet plays a very important role in determining your cholesterol levels. Foods high in trans fat, saturated fat, and salt can be especially dangerous. This includes:

  • Red meat
  • Whole milk and butter
  • Donuts, cookies, crackers, and other baked goods.
  • Fast food
  • Partially hydrogenated vegetable oils
  • Chicken with skin
  • Cured or processed meat

Many foods you find in the store can contain saturated and trans fats and are high in sodium, so read the nutritional information carefully before purchasing.

What is the biggest influence on LDL cholesterol?

Contrary to the belief that dietary cholesterol itself is the main cause of high LDL cholesterol, the evidence suggests a weaker association. It is still recommended to avoid cholesterol in the diet, but this is not the biggest impact. Current knowledge is that the specific combination of carbohydrates and fat in your diet is the most important factor in determining your LDL level.

Get the word of drug information

Given how important cholesterol is to body processes and circulatory function, it is not surprising that many factors can cause high levels of LDL cholesterol. However, since there are so many dangers associated with it, determining what specific behavior, medications, or other problems are causing the problem can be key to solving it.

After all, there is no single method to raise LDL levels; what works for some does not work for others. Reaching a healthy level is more of a journey than an event. However, with the support of loved ones and under the guidance of healthcare professionals, cholesterol levels can be effectively controlled. The benefits of this work are, of course, endless.

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