As you visit the doctor over the years, you may notice certain numbers in your bloodwork slowly creeping up.

Cholesterol, a waxy substance found in every cell of your body, is vital to its functioning, helping build cells and key hormones. But too much of it can lead to health problems, including heart attacks and strokes, and as you age, your body becomes less efficient at clearing cholesterol from the blood. By the time you get older and start thinking about your cholesterol levels, it could already be too high for comfort. 

“Cholesterol is a silent risk factor; you cannot feel it building up in your arteries,” said Lisa Young, a registered dietitian nutritionist, author of “Finally Full, Finally Slim” and an adjunct professor of nutrition at New York University, adding that regular blood test screenings are the only way to determine where you stand. “The earlier you start paying attention to your cholesterol, the better your long-term heart health will be.”

Do cholesterol levels rise with age?

Cholesterol, especially LDL, the so-called “bad cholesterol,” builds up inside the walls of your arteries over time. This buildup, called plaque, narrows and hardens the arteries, causing health problems.

“Cholesterol levels generally increase as you get older, particularly through middle adulthood,” Young said. In men, LDL levels tend to rise until around age 60, then gradually decline. In women, cholesterol levels tend to stay lower than men’s until menopause, around age 50 to 55, at which point they often rise and can surpass men’s levels, she added.

These changes are driven by a few important factors. As you age, the liver’s ability to process and remove cholesterol slows down and the enzyme your body uses to make cholesterol becomes more active. Hormonal changes, including the drop in estrogen during menopause, and an increased tendency to gain more abdominal fat – which promotes inflammation and increases the production of “harmful cholesterol particles” – also contribute.

What are normal cholesterol levels?

Cholesterol is measured through a blood test called a lipid panel. The main cholesterol and blood fat names to pay attention to are LDL, HDL, and triglycerides. “Total cholesterol” measures the combined amount of LDL, HDL and VLDL in the blood. 

According to Young, guidelines for healthy adults have optimal LDL Cholesterol levels at less than 100 mg/dL, though 100 to 129mg/dL is “near optimal.” High levels would be 160 mg/dL or above. For HDL, the “good cholesterol,” 40 mg/dL or above would be healthy for men and 50 mg/dL or above would be healthy for women. Normal triglycerides are less than 150 mg/DL, and high is 200 mg/dL or above. An ideal total cholesterol would be less than 200 mg/dL, and 240 mg/dL or above would be considered high.

Young said an LDL cholesterol level of 190 mg/dL or higher is considered severely elevated and is a red flag, regardless of your age or other risk factors. Medication is typically recommended immediately. 

If total cholesterol is above 290 mg/dL, it is worth discussing genetic screening with your doctor, especially with a family history of early heart disease.