A cholesterol level of 6.5 mmol/L is considered very high. Learn about normal vs. high cholesterol levels according to age and gender
A cholesterol level of 6.5 mmol/L is considered very high. Your doctor will also look at ratios of your good and bad cholesterol and whether you have any risk factors of heart disease.
Cholesterol is a fat produced by the cells in the body and obtained from animal-based foods. Though it has a bad reputation, cholesterol is required for many body functions, including developing cell membranes, producing certain hormones, such as estrogen and progesterone, and producing vitamin D. It also helps the liver produce bile acids that help the body absorb fats during digestion. There are four types of cholesterol:
- Total cholesterol
- High-density lipoprotein or good cholesterol
- Low-density lipoprotein or bad cholesterol
- Very-low-density lipoproteins or triglycerides
What are normal cholesterol levels?
Normal total cholesterol levels are as follows:
- Healthy adults: Less than or equal to 5 mmol/L
- High-risk individuals: Less than or equal to 4 mmol/L
Table 1. Normal cholesterol according to age and gender
Under 19
Males and females
Less than 170 mg/dL
Less than 120 mg/dL
Less than 110 mg/dL
More than 45 mg/dL
Less than 150 mg/dL
Over 20
Males
125 mg/dL to 200 mg/dL
Less than 130 mg/dL
Less than 100 mg/dL
40 mg/dL or higher
Less than 150 mg/dL
Over 20
Females
125 mg/dL to 200 mg/dL
Less than 130 mg/dL
Less than 100 mg/dL
50 mg/dL or higher
Less than 150 mg/dL
What are high cholesterol levels?
High cholesterol levels are as follows:
- High: 5 to 6.4 mmol/l
- Very high: 6.5 to 7.8 mmol/l
- Extremely high: above 7.8 mmol/l
Under 19
Males and females
- Borderline: 170 to 199 mg/dL
- High: Greater than or equal to 200 mg/dL
- Borderline: 120 to 144 mg/dL
- High: Greater than or equal to 145 mg/dL
- Borderline: 110 to 129 mg/dL
- High: Greater than or equal to 130 mg/dL
- Borderline: 150 to 199 mg/dL
- High: 200 to 499 mg/dL
- Very high: Greater than 500 mg/dL
Over 20
Males
- Borderline: 200 to 239 mg/dL
- High: Greater than or equal to 239 mg/dL
- High: Greater than 130 mg/dL
- Borderline: 130 to 159 mg/dL
- High: 160 to 189 mg/dL
- Very high: Greater than 189 mg/dL
- Borderline: 150 to 199 mg/dL
- High: 200 to 499 mg/dL
- Very high: more than 500 mg/dL
Over 20
Females
- Borderline: 200 to 239 mg/dL
- High: Greater than or equal to 239 mg/dL
- High: Greater than 130 mg/dL
- Borderline: 130 to 159 mg/dL
- High: 160 to 189 mg/dL
- Very high: Greater than 189 mg/dL
- Borderline: 150 to 199 mg/dL
- High: 200 to 499 mg/dL
- Very high: Greater than 500 mg/dL
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What are risk factors for high cholesterol?
- Weight: Obesity can increase triglyceride levels
- Diet: Saturated and trans fats have the most impact on blood cholesterol levels
- Age: Cholesterol level rises with advancing age
- Gender: Men and postmenopausal women are more likely to develop high cholesterol
- Genetics: High cholesterol often runs in families
What are complications of high cholesterol?
- Coronary artery disease
- Hemorrhagic stroke
- Atherosclerosis (hardening of the arteries)
- Myocardial infarction
- Peripheral arterial disease
How is high cholesterol treated?
Lifestyle modifications
- Maintain a healthy weight
- Avoid trans fats and saturated fats, such as red meat, added sugar, and dairy products
- Eat heart-healthy foods, such as fruits, vegetables, poultry, fish, and whole grains
- Engage in regular exercise for at least 30 minutes a day 5 days a week
- Maintain healthy blood sugar and blood pressure levels
- Avoid or limit alcohol intake
- Avoid or limit tobacco and smoking
- Manage stress
Medications
- Statins lower cholesterol levels and reduce the risk of heart disease. Examples include:
- Atorvastatin
- Fluvastatin
- Lovastatin
- Pravastatin
- Rosuvastatin
- Simvastatin
- Pitavastatin
- Bile acid sequestrants work by increasing cholesterol utilization by the liver. Examples include:
- Fibrates reduce triglyceride levels and boost high-density lipoprotein cholesterol levels. Examples include:
- PCSK9 inhibitors such as alirocumab and evolocumab
- Selective cholesterol absorption inhibitors such as ezetimibe
- Adenosine triphosphate-citrate lyase (ACL) inhibitors such as bempedoic acid
