Cholesterol isn’t just a middle-age concern: What the American Heart Association recommends

But according to the American Heart Association (AHA), that’s a myth. Cholesterol doesn’t wait for middle age to cause problems, it can start affecting your heart health much earlier. In fact, the AHA recommends that all adults aged 20 or older have their cholesterol checked every four to six years, as long as their risk remains low. If you have risk factors like a family history of heart disease, high blood pressure, or diabetes, you may need to get tested more often.

The AHA suggests that children and young adults without other risk factors or a family history of early heart disease should have their cholesterol checked once between the ages of 9 and 11 and again between 17 and 21. If there’s a family history of early heart disease or very high cholesterol, earlier screenings, as early as age 2, are reasonable.

Familial hypercholesterolemia is a genetic condition that affects an estimated 1 in 212 U.S. adults. If it's picked up early, medication combined with a healthy diet and exercise can be very effective. So, if heart disease runs in your family, it’s even more important to start monitoring cholesterol levels early.

"A study published in Circulation in 2023 linked elevated childhood cholesterol levels with an increased risk of problems such as heart attack and stroke in midlife. A separate, long-term study found that LDL cholesterol levels in people aged 18 to 30 was associated with a key measure of arterial plaque 15 to 20 years later," the AHA says in a recent report.

What you eat and how active you are can significantly impact your cholesterol levels. The AHA recommends replacing saturated fats like butter and whole dairy products with healthy fats found in olive oil, fatty fish, nuts, and seeds. Regular physical activity, not smoking, and maintaining a healthy weight also play crucial roles in keeping your cholesterol in check.
For some, lifestyle changes alone aren’t enough to lower cholesterol. In these cases, medications like statins may be prescribed. The AHA emphasizes that the decision to start medication should be made in consultation with a healthcare provider, considering the benefits and potential risks.

The AHA recommends that adults 20 or older have their cholesterol checked every four to six years, as long as their risk remains low. These screenings can help detect potential issues early, allowing for timely intervention and better heart health outcomes.
Ignoring cholesterol until middle age is a risky move. Starting early with regular screenings, healthy lifestyle choices, and being aware of family history can set you on the path to better heart health. Remember, it’s never too early to start taking care of your heart.