High cholesterol is extremely common. Globally, about 39% of adults have raised total cholesterol levels. In the United States, roughly 10% of adults over 20 have total cholesterol above 240 mg/dL, the threshold considered “high.” That translates to nearly 25 million Americans.
What Counts as High Cholesterol
Total cholesterol below 200 mg/dL is considered desirable. Between 200 and 239 is borderline high, and 240 or above is high. For LDL cholesterol (the type most linked to heart disease), below 100 is ideal, 130 to 159 is borderline high, and anything 160 or above is high. Most screening focuses on total cholesterol and LDL together, since someone can have a normal total number but still carry too much LDL.
Who Gets It Most Often
High cholesterol peaks during middle age. Among U.S. adults, prevalence is highest in the 40 to 59 age group at about 15.7%. Adults 60 and older come in at 11.4%, and younger adults aged 20 to 39 have the lowest rate at 7.5%. The drop in older adults likely reflects a combination of cholesterol-lowering medication use and natural declines in cholesterol that happen with aging.
Race and ethnicity don’t appear to create large differences. CDC data from 2015 to 2018 found no significant variation in rates of high total cholesterol between non-Hispanic white, Black, Asian, and Hispanic adults in the U.S.
How It Differs Between Men and Women
The relationship between sex and cholesterol is more complicated than most people realize. It shifts throughout life. Girls actually start out with higher LDL and total cholesterol than boys. During the premenopausal years, roughly ages 20 to 50, women flip to a more favorable profile, with lower LDL and higher HDL (the protective type) compared to men. After menopause, the advantage reverses again. Women’s LDL climbs, and from middle age onward they tend to carry a more harmful cholesterol profile than men of the same age.
This pattern matters because heart disease risk in women is often underestimated during the post-menopausal years, precisely when their cholesterol numbers are worsening.
High Cholesterol in Children
It’s not just an adult problem. About 6.6% of U.S. children and adolescents aged 6 to 19 have high total cholesterol (200 mg/dL or above). When you include other markers like low HDL or high non-HDL cholesterol, roughly 16.5% of kids in that age range have at least one abnormal cholesterol measure. These numbers come from CDC data collected between 2021 and 2023.
The Genetic Form
Some people inherit a condition called familial hypercholesterolemia that causes very high cholesterol from birth, regardless of diet or exercise. The estimated prevalence is about 1 in 250 to 1 in 311 people, both in the U.S. and worldwide. That makes it one of the most common genetic disorders, yet it’s vastly underdiagnosed. People with this condition often have LDL levels above 190 mg/dL and face a significantly higher risk of early heart disease if untreated. If high cholesterol runs strongly in your family, especially with heart attacks before age 55 in men or 65 in women, this genetic form is worth investigating.
Treatment Rates
Among adults who know they have high cholesterol, only about 54% take a prescription cholesterol-lowering medication. Of those who do take one, the vast majority (93%) use a statin. That means a significant portion of people with diagnosed high cholesterol are either managing it through lifestyle changes alone, have stopped taking prescribed medication, or simply aren’t treating it at all.
The gap between diagnosis and treatment is notable because high cholesterol produces no symptoms on its own. There’s no pain, no fatigue, no visible sign. The damage accumulates silently in artery walls over years, which is why routine blood testing is the only way to catch it. Many adults go years between screenings, and the condition can progress substantially in that time.