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High "bad" cholesterol, or hypercholesterolemia, affects about 10% of adults in the United States and about 7% of youth, according to .

Genetics are one major reason for high cholesterol levels. Millions of different genetic variants may have a small contribution that adds up to impact how the body transports and disposes of cholesterol that might otherwise end up as problematic blockages in the blood vessels. Up to half of the levels from one person to the next appears to be due to the genes they inherit.

About one in 250 people have one or two mutated copies of key cholesterol genes that result in familial hypercholesterolemia. These individuals are at high risk of early heart disease from severely elevated "bad" low-density lipoprotein (LDL) cholesterol levels (over 190 mg/dL in adults and over 160 mg/dL in children).

However, there are contributors to hypercholesterolemia that depend on you. A poor diet with lots of -- such as from fatty or processed meats, cheeses, and butter -- increases your cholesterol levels. Exercise also makes a difference, with one showing that the more physical activity you get per week the better your lipid profile beyond just LDL or weight. Use of tobacco products lowers "good" high-density lipoprotein (HDL) cholesterol, particularly in women, and raises LDL cholesterol.

Fewer women than men have high cholesterol before age 40, but a woman's risk rises after menopause due to a reduction in female hormones that appear protective. appears to matter as well, as non-Hispanic white people have higher levels of total cholesterol and Asian Americans have higher LDL cholesterol than other groups do.

As we get older, a declining metabolism means the liver does not remove LDL cholesterol as well as it once did, leading to a higher risk of hypercholesterolemia.

You might also be more likely to develop high cholesterol if you have a condition like obstructive liver disease, diabetes, hypothyroidism, chronic kidney failure, or nephrotic syndrome.

Taking certain medications -- like the heart drugs amiodarone (Pacerone or Cordarone) and hydrochlorothiazide (Oretic or Microzide) or the antibiotic cyclosporine (Neoral or Gengraf) -- also contribute to elevated risk.

Read previous installments in this series:

For Your Patients: Hypercholesterolemia: Understanding Your Diagnosis

For Your Patients: Why Do High Cholesterol Levels Matter?

"Medical Journeys" is a set of clinical resources reviewed by doctors, meant for physicians and other healthcare professionals as well as the patients they serve. Each episode of this journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.