Cholesterol is a fat-like substance that plays a major role in heart health. According to the American Heart Association, high cholesterol is considered to be 240 milligrams per deciliter (mg/dL) and above. The National Cholesterol Education Program's (NCEP's) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults creates updated clinical guidelines for testing and management of cholesterol. The third version, Adult Treatment Panel III or ATPIII, was published in 2001.
Types
Elevated low-density lipoprotein (LDL) or "bad" cholesterol is a major cause of heart disease. LDL cholesterol can build up on the inside of artery walls, contributing to artery blockages that can lead to heart attacks. High-density lipoprotein (HDL) cholesterol is known as "good" cholesterol because it helps prevent arteries from becoming clogged. Triglycerides are a type of fat often increased by sweets and alcohol in the diet.
Classification
Blood cholesterol for adults is classified by levels. According to the American Heart Association an LDL level of 100 to 129 mg/dL is considered near or above optimal. A level of 130 to 159 mg/dL is considered borderline high and 160 to 189 mg/dL is considered high. Levels of 190 mg/dL and above are considered very high. Total cholesterol levels of 200 to 239 mg/dL are considered borderline high and a value of 240 mg/dL and above is high cholesterol.
Measurement
A fasting lipoprotein profile including total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides should be obtained at least once every five years in adults age 20 years and over, according to ATPIII. More frequent measurements are required for persons with multiple risk factors. In otherwise low-risk persons, further testing is not required if the HDL-cholesterol level is greater than or equal to 40 mg/dL and total cholesterol is less than 200 mg/dL. However, for persons with multiple risk factors, lipoprotein measurement is recommended as a guide to clinical management.
Risk Factors
High cholesterol has no symptoms. It occurs mainly as a result of genetic makeup reflected in family history of high cholesterol or heart disease and other risk factors that can predispose someone to high cholesterol. If you are already diagnosed with coronary heart disease, atherosclerosis or diabetes, your LDL cholesterol guidelines are for the high risk category, even if there are no other symptoms of heart disease. The major independent risk factors identified include cigarette smoking, hypertension, low HDL cholesterol, family history of premature coronary heart disease and age.
Treatment
Reducing the amount of saturated fat, trans fat, cholesterol and total fat in the diet can help lower cholesterol levels and help prevent heart disease. With high blood cholesterol, it's very important to control high blood pressure, avoid tobacco smoke, eat a healthy diet, get regular physical activity, maintain a healthy weight, and control or delay the onset of diabetes. If medication is needed to reduce blood cholesterol, a healthy diet and active lifestyle will help lower cholesterol levels and will help improve overall cardiovascular health.
References
- Cleveland Clinic: Cholesterol Guidelines
- American Heart Association: Cholesterol Levels
- MayoClinic.com: Cholesterol levels: What numbers should you aim for?
- National Heart, Lung and Blood Institute: Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III Final Report)
