Cholesterol levels by age
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Age-Related Trends in Cholesterol Levels
Cholesterol levels change with age, and these changes differ between men and women. In general, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) tend to rise with age until middle age, then decline in older adults. High-density lipoprotein cholesterol (HDL-C) patterns are less predictable but are usually higher in women than men across all ages 16.
Cholesterol Levels in Young Adults and Middle Age
In both men and women, cholesterol levels increase with age up to about 40–60 years. For men, TC, TG, and LDL-C rise until around age 40–60, then start to decrease. For women, these levels rise until about age 60–70, then decline. Notably, women’s cholesterol levels are lower than men’s before age 50, but after menopause, women’s levels often surpass men’s 16.
Cholesterol Prevalence by Age Group
In the U.S., the prevalence of high total cholesterol (defined as ≥240 mg/dL) is highest among adults aged 40–59 years (about 15–17%), lower in those aged 60 and older (about 11–12%), and lowest in adults aged 20–39 years (about 6–7%) 234. Among men, high cholesterol is most common in the 40–59 age group and drops in older age. Among women, the prevalence is lowest in young adults, peaks in middle age, and remains relatively high in older age, often higher than in men of the same age 234.
Long-Term Trends and Birth Cohorts
Over recent decades, average cholesterol levels have declined in many populations, likely due to better diet, lifestyle changes, and increased use of cholesterol-lowering medications. However, within each birth cohort, cholesterol typically rises with age to a peak in midlife, then falls in older age . This pattern is seen in both men and women.
Cholesterol in Older Adults: The Paradox
In older adults, lower cholesterol levels are sometimes linked to higher mortality, a phenomenon known as the "cholesterol paradox." This may be because low cholesterol in older age can reflect poor health or nutritional status rather than being protective. Some studies suggest that cholesterol is important for body functions in the elderly, and very low levels may not always be beneficial 89.
Special Populations: Familial Hypercholesterolemia
In people with familial hypercholesterolemia (FH), age is also an independent factor affecting cholesterol levels. Those aged 50 and older with FH have significantly higher cholesterol than younger individuals with FH, highlighting the importance of early screening and intervention .
Conclusion
Cholesterol levels generally increase with age until middle age, then decline in older adults. Women’s cholesterol levels rise later and can surpass men’s after menopause. The highest prevalence of high cholesterol is seen in middle-aged adults. In older adults, the relationship between cholesterol and health outcomes becomes more complex, and very low cholesterol may signal other health issues. Understanding these age-related patterns is important for assessing cardiovascular risk and guiding treatment decisions 123468910.
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