Nearly 25 million adults in the United States have total cholesterol above 240 mg/dL, the threshold doctors classify as high. Globally, about 39% of adults have elevated total cholesterol. These numbers make high cholesterol one of the most common cardiovascular risk factors in the world.
High Cholesterol in the US by the Numbers
The most recent national survey data, covering August 2021 through August 2023, found that 11.3% of US adults aged 20 and older have high total cholesterol. That’s roughly 1 in 9 adults walking around with a total cholesterol reading of 240 mg/dL or higher. Earlier estimates from 2017 to 2020 placed the figure at about 10%, suggesting the rate has held relatively steady or ticked slightly upward in recent years.
Men and women are affected at nearly identical rates. Age-adjusted estimates show 11.0% of men and 11.3% of women have high total cholesterol. Race and ethnicity don’t appear to create large gaps either. CDC survey data found no significant differences in the prevalence of high total cholesterol between non-Hispanic white, non-Hispanic Black, non-Hispanic Asian, and Hispanic adults.
The Global Picture
Outside the US, the numbers are striking. The World Heart Federation estimates that 39% of adults worldwide have raised total cholesterol. That figure is considerably higher than the US rate, largely because it uses a lower cutoff (total cholesterol at or above 190 mg/dL in many international guidelines) and reflects wide variation between countries and regions. Western Europe, for instance, has historically had some of the highest average cholesterol levels of any region, while parts of sub-Saharan Africa and South Asia tend to have lower averages, though rates are climbing as diets shift toward more processed and high-fat foods.
Children and Adolescents Are Affected Too
High cholesterol isn’t limited to adults. National survey data from 2021 to 2023 found that 16.5% of US children and adolescents had at least one abnormal cholesterol measure, whether that was high total cholesterol, low “good” cholesterol (HDL), or high non-HDL cholesterol. Looking at total cholesterol alone, 6.6% of young people had levels at or above 200 mg/dL, which is the high threshold for anyone under 20. Another 6.7% had elevated non-HDL cholesterol, and 9.2% had low HDL cholesterol.
These numbers matter because cholesterol buildup in artery walls can begin in childhood. Kids with persistently high levels are more likely to carry those levels into adulthood, which increases their long-term risk of heart disease and stroke.
What Counts as High Cholesterol
The numbers that define “high” depend on your age and which type of cholesterol is being measured. For adults 20 and older, a total cholesterol below 200 mg/dL is considered healthy. Between 200 and 239 is borderline high, and 240 or above is high. For LDL cholesterol (the type most strongly linked to artery-clogging plaque), below 100 mg/dL is the target. HDL cholesterol works in reverse: higher is better, with 60 mg/dL or above considered protective.
For children and teens 19 and younger, the thresholds are lower. Total cholesterol should be under 170 mg/dL, and LDL should stay below 110 mg/dL. HDL above 45 mg/dL is the goal.
Triglycerides, a related type of blood fat, are considered borderline high at 150 to 199 mg/dL and high at 200 mg/dL or more.
Low HDL Is a Separate Problem
Most conversations about “high cholesterol” focus on total cholesterol or LDL, but having too little HDL cholesterol is its own risk factor. HDL helps clear excess cholesterol from your bloodstream, so low levels leave more of it circulating and available to build up in artery walls.
In the US, low HDL (below 40 mg/dL) affects about 16.6% of non-Hispanic white adults, 15.8% of non-Hispanic Asian adults, 11.9% of non-Hispanic Black adults, and 21.9% of Hispanic adults. The gap is most pronounced among men: nearly 32% of Hispanic men have low HDL, compared with about 26% of white and Asian men and 17% of Black men. Among women, the differences narrow, though Hispanic women still have the highest rate at 12.3%.
Why the Numbers Likely Undercount the Problem
The 11.3% figure for high total cholesterol in US adults uses 240 mg/dL as the cutoff, which captures only the most elevated cases. It doesn’t count the large number of people sitting between 200 and 239, a range considered borderline high and still associated with increased cardiovascular risk. It also doesn’t capture people whose total cholesterol looks fine but whose LDL is too high or whose HDL is too low. When you factor in all forms of unhealthy cholesterol, the share of adults with at least one lipid abnormality is substantially higher than 1 in 9.
High cholesterol also produces no symptoms on its own. You can’t feel it the way you’d feel a fever or a sore joint, so many people have it without knowing. The only way to detect it is through a blood test, typically a lipid panel drawn after fasting. Current guidelines recommend most adults get their first screening by age 20 and repeat it every four to six years if their levels are normal. People with risk factors like a family history of heart disease, diabetes, or obesity may need testing more often.