complete cholesterol profile in 5 minutes
Cholesterol is a soft, waxy substance found among the lipids
(fats) in the bloodstream and in all your body's cells. It is
normal to have cholesterol. It's an important part of a healthy
body because it's used to form cell membranes, some hormones and
other needed tissues. But too high a level of cholesterol in the
blood is a major risk for coronary heart disease, which leads
to heart attack. It's also a risk factor for stroke. Hypercholesterolemia
is the term for high levels of blood cholesterol.
You get cholesterol in two ways. Your body makes some of it,
and the rest comes from animal products that you eat, such as
meats, poultry, fish, eggs, butter, cheese and whole milk. Food
from plants like fruits, vegetables and cereals do not have cholesterol.
Cholesterol and other fats can't dissolve in the blood. They
have to be transported to and from the cells by special carriers
called lipoproteins. There are two kinds that you need to be concerned
with. Low-density lipoprotein, or LDL, is known as the "bad"
cholesterol. Too much LDL cholesterol can clog the arteries to
your heart and increase your risk of heart attack. High-density
lipoprotein, or HDL, is known as the "good" cholesterol.
Your body makes HDL cholesterol for your protection. It travels
away from your arteries. Studies suggest that high levels of HDL
cholesterol reduce your risk of heart attack.
What's the Difference Between LDL and HDL
Why is LDL cholesterol considered "bad"?
A high level (more than 160 mg/dL or higher than 130 mg/dL if
you have two or more risk factors for cardiovascular disease)
of low-density lipoprotein, or LDL cholesterol, reflects an increased
risk of heart disease. That's why LDL cholesterol is often called
"bad" cholesterol. Lower levels of LDL cholesterol reflect
a lower risk of heart disease. When too much LDL cholesterol circulates
in the blood, it can slowly build up in the walls of the arteries
that feed the heart and brain. Together with other substances
it can form plaque, a thick, hard deposit that can clog those
arteries. This condition is known as atherosclerosis.
If a clot (thrombus) forms where a plaque is, the blood flow can
be blocked to part of the heart muscle, causing a heart attack.
If a clot blocks blood flow to part of the brain, a stroke results.
The levels of HDL cholesterol and LDL cholesterol in the blood
are measured to evaluate the risk of having a heart attack.
What is Lp(a) cholesterol?
Lp(a) is a genetic variation of plasma LDL. A high level of
Lp(a) is an important risk factor for developing atherosclerosis
prematurely. The way an increased Lp(a) contributes to disease
isn’t understood. The lesions in artery walls contain substances
that may interact with Lp(a), leading to the buildup of lipids
in atherosclerotic plaques.
Why is HDL cholesterol considered "good"?
About one-third to one-fourth of blood cholesterol is carried
by high-density lipoprotein (HDL). HDL cholesterol is known as
the "good" cholesterol because a high level of HDL cholesterol
seems to protect against heart attack. Medical experts think that
HDL tends to carry cholesterol away from the arteries and back
to the liver, where it is passed from the body. Some experts believe
that excess cholesterol is removed from atherosclerotic plaque
by HDL, thus slowing the build-up. However, low HDL cholesterol
levels (lower than 40 mg/dL) may result in a greater risk for
What is triglyceride?
Triglyceride is a form of fat. It comes from food and is also
made in your body. People with high triglycerides often have a
high total cholesterol, a high LDL cholesterol and a low HDL cholesterol
level. Many people with heart disease also have high triglyceride
levels. Several clinical studies have shown that people with above-normal
triglyceride levels (greater than or equal to 200 mg/dL) have
an increased risk of heart disease. Doctors need to treat high
triglycerides in people who also have high LDL cholesterol levels.
People with diabetes or who are obese are also likely to have
What are healthy levels of cholesterol?
Your total blood cholesterol level
Your total blood cholesterol will fall into one of these categories:
Desirable -- Less than 200 mg/dL
Borderline high risk -- 200-239
High risk -- 240 mg/dL and over
If your total cholesterol is less than 200 mg/dL, your heart
attack risk is relatively low, unless you have other risk factors.
Even with a low risk, it's still smart to eat foods low in saturated
fat and cholesterol, as well as get plenty of physical activity.
Have your cholesterol levels measured every five years or more
often if you?re a man over 45 or a woman over 55.
Borderline high risk
In general, people who have a total cholesterol level of 240
mg/dL have twice the risk of heart attack as people who have a
cholesterol level of 200 mg/dL. About a third of American adults
are in the borderline group, while almost half of adults have
total cholesterol levels below 200 mg/dL. Have your cholesterol
and HDL rechecked in one to two years if:
- Your total cholesterol is in this range
- Your HDL is less than 40 mg/dL
- You don’t have other risk factors for heart disease
You should also lower your intake of foods high in saturated
fat and cholesterol to reduce your cholesterol level to below
200. Your doctor may order another blood test to measure your
LDL cholesterol. Ask your doctor to discuss your LDL cholesterol
with you. Even if your cholesterol is between 200 and 239 mg/dL,
you may not be at high risk for a heart attack. Some people, such
as women before menopause, and young, active men who have no other
risk factors, may have high HDL cholesterol and desirable LDL
levels. Ask your doctor to interpret your results. Everyone's
case is different.
If your total cholesterol level is 240 or
more, it's definitely high. Your risk of heart attack and,
indirectly, of stroke is greater. You need more tests. Ask your
doctor for advice. About 20 percent of the U.S. population has
high blood cholesterol levels.
Your LDL cholesterol level
Your LDL cholesterol level greatly affects your risk of heart
attack and, indirectly, of stroke. The lower your LDL cholesterol,
the lower your risk. In fact, it’s a better gauge of risk
than total blood cholesterol. Your LDL cholesterol will fall into
one of these categories:
Desirable -- less than 130 mg/dL
Borderline high risk -- 130-159
High risk -- 160 mg/dL or higher
The key point to remember is, the lower your LDL cholesterol,
the lower your risk. Your doctor may prescribe a diet low in saturated
fat and cholesterol, regular exercise and a weight management
program if you're overweight. If you can't lower your cholesterol
with these efforts, medications may also be prescribed to lower
your LDL cholesterol. Check these categories and the goals for
treatment that can lower your risk of heart attack.
|People without coronary heart
disease and with fewer than two risk factors
||190 mg/dL or higher*
||160 mg/dL or lower
|People without coronary heart disease
and with two or more risk factors
||160 mg/dL or higher
||130 mg/dL or lower
|People with coronary heart disease
||130 mg/dL or higher**
||100 mg/dL or lower
*In men less than 35 years of age and premenopausal women with
LDL cholesterol levels of 190 to 219 mg/dL, drug therapy should
be delayed except in high-risk patients such as those with diabetes.
**In coronary heart disease patients with LDL cholesterol levels
of 100 to 129 mg/dL, the doctor should consider whether to initiate
drug treatment in addition to the American Heart Association Step
If you do not know if you have other risk factors for heart disease,
check out the American Heart Association's list by clicking here.
Your HDL cholesterol level
In the average man, HDL cholesterol levels range from 40 to
50 mg/dL. In the average woman, they range from 50 to 60 mg/dL.
HDL cholesterol that';s less than 40 mg/dL is low. Low HDL cholesterol
puts you at high risk for heart disease. Smoking, being overweight
and being sedentary can all result in lower HDL cholesterol. If
you have low HDL cholesterol, you can help raise it by:
- Not smoking
- Losing weight (or maintaining a healthy weight)
- Being physically active for at least 30-60 minutes a day on
most days of the week.
People with high blood triglycerides usually have lower HDL cholesterol
and a higher risk of heart attack and, indirectly, of stroke.
Progesterone, anabolic steroids and male sex hormones (testosterone)
also lower HDL cholesterol levels. Female sex hormones raise HDL
The American Heart Association recommends that the absolute
numbers for total blood cholesterol and HDL cholesterol levels
be used. They are more useful to the physician than the cholesterol
ratio in determining the appropriate treatment for patients.
Total blood cholesterol is the most common measurement of blood
cholesterol. It is the number you normally receive as test results.
Cholesterol is measured in milligrams per deciliter of blood (mg/dL).
Knowing your total blood cholesterol level is an important first
step in determining your risk for heart disease. However, a critical
second step is knowing your HDL or "good" cholesterol
Some physicians and cholesterol technicians use the ratio of
total cholesterol to HDL cholesterol in place of the total blood
The ratio is obtained by dividing the HDL cholesterol level into
the total cholesterol. For example, if a person has a total cholesterol
of 200 mg/dL and an HDL cholesterol level of 50 mg/dL, the ratio
would be stated as 4:1. The goal is to keep the ratio below 5:1;
the optimum ratio is 3.5:1.
Your triglyceride level
Your triglyceride level will fall into one of these categories:
|Less than 150 mg/dL
500 mg/dL or higher
any people with high triglycerides have underlying diseases or
genetic disorders. If this applies to you, the main therapy is
to change your lifestyle. This includes controlling your weight,
eating foods low in saturated fat and cholesterol, exercising
regularly, not smoking and, in some cases, drinking less alcohol.
People with high triglycerides may also need to limit their intake
of carbohydrates to no more than 45–50 percent of total
calories. The reason for this is that carbohydrates raise triglycerides
and lower HDL cholesterol. Use products with monounsaturated and
Special Message for Women
As a rule, women have higher HDL cholesterol levels than men.
The female sex hormone estrogen tends to raise HDL cholesterol,
which may help explain why premenopausal women are usually protected
from developing heart disease. Estrogen production is highest
during the childbearing years. Women also tend to have higher
triglyceride levels. Triglyceride levels range from about 50 to
250 mg/dL, depending on age and sex. As people get older, more
overweight or both, their triglyceride and cholesterol levels
tend to rise.
Hormone replacement therapy (HRT) may benefit some women with
osteoporosis or other medical conditions associated with menopause.
Women with a personal or family history of breast cancer or other
endocrine-related cancers should not receive HRT. The HERS trial
in women who had previously had a heart attack showed that these
women did not benefit from HRT. Recent clinical trials appear
to confirm that HRT does not appear to reduce risk of cardiovascular
disease and stroke in post menopausal women.
The American Heart Association recommends the use of statins
as the first line of drug therapy for women with heart disease.
This should be combined with a low-fat, low-cholesterol diet,
weight management and regular exercise. Statin drugs are very
effective for lowering LDL cholesterol levels and have few immediate
short-term side effects. They work by interrupting the formation
of cholesterol from the circulating blood.