Along with obesity, cigarette smoking, hypertension, diabetes and a sedentary lifestyle, high cholesterol is a primary risk factor for heart disease. According to the American Heart Association, more than 98 million adults have total cholesterol values that exceed 200 mg/dl. Over 34 million have levels higher than 240 mg/dl that put them at considerable risk for a heart attack or stroke. What may surprise many is that not all cholesterol is bad. Some forms actually help prevent the incidence of heart disease. But, to ensure that you're doing all you can to ward off serious cardiovascular complications, it's important to understand the differences between the types of cholesterol and what you can do to manage them.
Understanding Blood Lipid Tests
Chances are, when you make an appointment for an annual physical examination with your family physician, he will ask you to fast for at least 12 hours before you arrive at the office. This is to make sure you'll get accurate results from a blood lipid test he'll perform. Blood lipid tests measure your total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides, and will help to determine your risk for heart disease. Each of the values tells you something about your diet, exercise habits and general health routines.
Total Cholesterol
At one time, total cholesterol values were the most important factor in determining your risk for having a heart attack. Since then, researchers have discovered that the sub-components of your cholesterol reveal more about your health and offer better solutions. According to the American Heart Association, the acceptable range for total cholesterol is 200 mg/dl or less. If your values are higher, don't feel alone---over 34 million Americans have cholesterol levels higher than 240 mg/dl, putting them at high risk. Cholesterol levels between 200 and 239 are considered borderline risk for heart disease.
LDL Levels
The major culprit for accelerating heart disease is low density lipoproteins, or LDL. LDL is often called the "bad" cholesterol because it hastens the accumulation of cholesterol and saturated fat on the inside of the arterial walls. Over time, LDL cholesterol can become calcified and completely cut off the blood supply to the heart through the coronary arteries. When this occurs, a heart attack can ensue. If the plaque has accumulated over long enough periods of time, there is a likelihood of it breaking off and becoming lodged downstream.
NCEP Recommendations
The American Heart Association's National Cholesterol Education Program (NCEP) guidelines recommend that everyone over the age of 20 have a lipoprotein profile once every five years. The program recommends that adults strive to keep their LDL cholesterol levels lower than 100 mg/dl. One hundred to 129 mg/dl is near or above optimal, 130 to 159 mg/dl is borderline high, 160 mg/dl to 189 mg/dl is high and 190 and above is considered very high.
LDL Levels in Context
In addition to monitoring LDL levels specifically, it's important to temper the results in conjunction with how many other risk factors you have. If there is no heart disease in your family---and if you're free from coronary artery disease, diabetes and have no other cardiac risk factors---attempt a goal of 160 mg/dl. If you're free of coronary heart disease, diabetes and have two or more cardiac risk factors, your LDL goal should be 130 md/dl or less. If you currently have coronary artery disease or diabetes, your LDL goal should be less than 100 mg/dl.
