You Need to Understand Your Cholesterol Numbers

What is Cholesterol?

Cholesterol is a waxy substance found in all cells of the body. It is essential for normal function. Cholesterol is also used by the body to make some hormones and other chemicals. About two thirds of the body’s cholesterol is made and stored in the liver. A high level of cholesterol in the blood is known as hypercholesterolemia. High blood cholesterol increases the chance of having a heart attack, stroke or chest pain. There are usually no symptoms of high cholesterol which is why everyone over the age of 20 should get their cholesterol checked every 5 years.

Once the results of the cholesterol test are available it is important to understand what these numbers mean. Cholesterol is carried through the blood stream on lipoproteins. There are three major categories of lipoproteins which are typically measured. These are HDL (high density lipoprotein), LDL (low density lipoprotein), VLDL (very low density lipoprotein).

Total Cholesterol (mg/dl)
Less Than 200	Good
200 to 239	Borderline High
240 and over	High

HDL are considered “good cholesterol” because they carry cholesterol from the body to the liver. This is good because the liver is responsible for removing cholesterol from the body. A high HDL will reduce your chances of heart disease.

HDL Cholesterol (mg/dl)
Less Than 40	Major heart disease risk
40 to 59	The higher the better
60 and above	Considered heart protective

LDL are considered “bad cholesterol” because they carry cholesterol from the liver out to the body. This is not a good thing because a high LDL is associated with an increased chance of premature heart disease and death.

LDL Cholesterol (mg/dl)
Less Than 100	Optimal
100 to 129	Near but above optimal
130 to 159	Borderline high
160 to 189	High
190 and above	Very High

VLDL are also considered to be bad because they carry triglycerides from the liver to the body. A high triglyceride level is also associated with heart disease.

Triglycerides (mg/dl)
Less than 150	Normal
150 to 199	Borderline high
200 to 499	High
Greater than 500	Very High

To get a handle on what your goal is for an ideal LDL cholesterol you need to know what your 10 year risk for heart disease. You can access the National Cholesterol Education Program’s 10 year risk calculator here. Once you know this number then find you LDL goal below.

LDL (mg/dl) Goal by Risk Level
High Risk – You have heart disease, diabetes OR a risk score of 20% or more.	Goal is less than 100
Moderate high risk – You have 2 or more risk factors and a risk score of 10 to 20%	Goal is les than 130
Moderate risk – You have 2 or more risk factors and a risk score less than 10%	Goal is less than 130
Low Risk – You have 0 or 1 risk factor	Goal is less than 160

Risk factors:

• Cigarette smoking,
• High blood pressure (140/90 or higher or on blood pressure medication)
• Low HDL (less than 140mg/dl)
• Family history of heart disease (in father or brother before age 55, in mother or sister before age 65)
• Male 45 years or older, female 55 years or older

Understanding your cholesterol numbers and how they affect your risk in development of heart disease is essential. With this information you can work with your doctor to develop a plan to improve your numbers and to reduce your risk. Medication may be needed to help you achieve your goal. In all cases, lifestyle changes will be required to achieve the maximum benefit and reduce your risks the most.

A great resource to help you make lifestyle changes to lower cholesterol can be found at the National Heart Lung and Blood institute website here. Your Guide to Lowering Cholesterol with Therapeutic Lifestyle Changes (TLC) You can print a free copy off the site or you can order a copy by calling 301-592-8573.

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