Too much cholesterol in the blood increases your risk for heart disease, heart attack and stroke. According to the American Heart Association, heart disease is the leading cause of death in the United States. Nearly 2,300 Americans die of heart disease every day---one death every 38 seconds. Fortunately, you can lower your cholesterol level and reduce your risk for heart disease and stroke. Be informed about healthy cholesterol (lipid) levels and make lifestyle changes to improve your lipid profile.
Total Cholesterol
Your health care provider can measure your lipid profile, a blood test that screens for total cholesterol, LDL ("bad") cholesterol, HDL ("good") cholesterol and triglycerides. Total cholesterol is a composite of LDL and HDL cholesterols and a fraction of the triglycerides. Having an elevated LDL cholesterol or triglyceride level will tend to lead to an elevated total cholesterol.
According to the American Heart Association (AHA), high cholesterol is one of the major controllable risk factors for heart disease, heart attack and stroke. Other risk factors include high blood pressure, diabetes and tobacco smoke. Your cholesterol level may be affected by age, gender, family history and diet. For total cholesterol, less than 200 mg/dL is desirable; 200 to 239 mg/dL is borderline high; and 240 mg/dL or higher is considered high. Having a high cholesterol level doubles your heart disease risk compared with those who have a level <200 mg/dL.
LDL Cholesterol
LDL cholesterol is the bad kind. When there is too much in the blood, it can cause atherosclerosis. LDL slowly builds up along the inner walls of arteries that feed the heart and brain. With other substances---platelets, cellular debris, calcium---it forms plaque, a thick, hard deposit that narrows the arteries and makes them less flexible. If a clot forms and blocks a narrowed artery it can cause a heart attack or stroke. LDL is produced naturally by the liver; some people genetically make too much. LDL is also affected by saturated fat, trans fats and cholesterol in your diet.
For LDL cholesterol, <100 mg/dL is optimal; 100 to 129 mg/dL is near or above optimal; 130-159 mg/dL is borderline high; 160-189 is high; and 190 mg/dL or above is very high. However, your doctor will look at your other risk factors for heart disease and stroke in determining what your LDL level should be. For example, diabetes is such a strong risk factor for heart disease that, if you have this condition, the American Diabetes Association recommends aiming for an LDL <100 mg/dL. To lower LDL cholesterol, decrease saturated fat, trans fat and cholesterol, replacing them with heart-healthy mono- and polyunsaturated fats.
HDL Cholesterol
HDL cholesterol, on the other hand, is the good kind. Medical experts believe that it carries cholesterol away from the arteries and back to the liver, where it is eliminated from the body. It may also remove excess cholesterol from plaque, slowing its buildup. A higher level of HDL cholesterol may therefore protect against heart attack and stroke.
Aim for an HDL cholesterol level of 60 mg/dL or higher to reap its protective benefits. For men, less than 40 mg/dL is considered low; for women, less than 50 mg/dL is low. A low HDL level is a major risk factor for heart disease. To improve HDL levels, increase physical activity, reduce trans fat intake and eat a balanced, nutritious diet.
Triglycerides
Triglycerides are a form of fat made by the body. When we eat excess calories, they are converted to triglycerides for storage. People with elevated triglycerides often have low HDL and/or high LDL, which speeds up atherosclerosis. High triglycerides have many causes---overweight or obesity, physical inactivity, cigarette smoking, excess alcohol intake or a diet in which more than 60 percent of calories come from carbohydrate. Many people with heart disease and/or diabetes also have high triglycerides.
For triglycerides, less than 150 mg/dL is considered normal; 150-199 mg/dL is borderline high; 200-499 mg/dL is high; and 500 mg/dL or higher is very high. Triglycerides over 150 mg/dL is a risk factor of metabolic syndrome, which increases risk for heart disease and diabetes. According to the AHA the main therapy for elevated triglycerides is lifestyle changes. Control your weight, eat a heart-healthy diet, get regular physical activity, avoid tobacco smoke, limit alcohol and limit beverages and foods with added sugars.
Ratios
Your lipid panel results may also include cholesterol ratios. According to eMedTV, HDL/LDL looks at the ratio of HDL to LDL cholesterol. If your HDL is 50 mg/dL and your LDL is 150 mg/dL, the HDL/LDL ratio would be 0.33. The goal is to keep this ratio above 0.3, with above 0.4 being ideal. Another ratio to look at is triglycerides to HDL cholesterol (TG/HDL). A high TG/HDL ratio increases risk for heart disease and heart attack, according to the Harvard School of Medicine. It is also associated with insulin resistance, a characteristic of metabolic syndrome and diabetes. TG/HDL less than 2.0 is considered good; over 3.5 is a sign of insulin resistance.
