Millions of Americans Have High Cholesterol—Many Don't Know Their Options

February is American Heart Month, and health experts are urging people to pay closer attention to their cholesterol levels—a key factor in heart disease risk that often goes unnoticed.

Cholesterol is a waxy substance the body needs in small amounts, but excess levels can restrict blood flow to the heart, leading to chest pain, heart attacks, or strokes. Nearly 25 million U.S. adults age 20 and older have total cholesterol levels considered high, and about 86 million in that age group have borderline high levels. Because high cholesterol typically doesn't cause symptoms, the only way to know your numbers is through testing.

"It's very common that patients don't know their cholesterol levels," said Dr. Laxmi Mehta, Director of Preventative Cardiology at The Ohio State University Wexner Medical Center.

Lifestyle changes—eating a heart-healthy diet low in saturated fats, exercising, losing weight, and quitting smoking—can help lower cholesterol. But sometimes that's not enough, and medication becomes necessary. Currently, slightly more than half of U.S. adults who could benefit from cholesterol medication are actually taking it.

While statins remain the cornerstone treatment, Mehta noted that not everyone can tolerate them—and many patients don't realize alternatives exist. Both pill and injectable options are available for those who are statin-intolerant or need additional treatment to manage their levels.

High LDL cholesterol is associated with plaque buildup in heart and neck arteries, which can lead to strokes. Beyond lowering LDL numbers, Mehta said, medications can also stabilize existing plaque and slow its progression.