More than 16 percent of Americans have high cholesterol, the Centers for Disease Control and Prevention reports. If you fall into that category, you have a higher risk of developing heart disease, which is the leading cause of death in the United States. When your doctor checks your cholesterol, you'll typically get three readings back: your total cholesterol, your "bad" cholesterol and your "good" cholesterol. Your health care provider will decide on formal treatment with high readings in the total and "bad" categories, although a low reading in the good category is also cause for concern.
Total Cholesterol
Your cholesterol is carried throughout your body in special protein carriers called lipoprotein. Cholesterol tests actually measure these proteins. The National Cholesterol Education Program, a service of the National Institutes of Health's National Heart, Lung and Blood Institute, sets guidelines regarding cholesterol readings, classifying them as "optimal or desirable," "borderline high," "high" and "very high" throughout a range of measurements. Your total cholesterol is usually the sum of your good and bad cholesterol, and sometimes includes another lipoprotein that carries mostly triglycerides. When your total cholesterol reading is lower than 200 mg/dL, it's "desirable" by these standards. When it's between 200 mg/dL and 239 mg/dL, it's borderline high, and if it's greater than 240 mg/dL, it's high. The American Heart Association says at 240 mg/dL, you have twice the risk of coronary heart disease as a person who has a reading of 200 mg/dL or less.
Bad Cholesterol
Low-density lipoprotein, or LDL, is the boogeyman you want to see less of. Although in reality LDL conducts important functions such as assisting with metabolism, cell repair and hormone production, too much of it can clump with other substances and form plaques in your blood vessels. If it blocks your blood flow, this circumstance can lead to heart attack or stroke. When your LDL is high, your health care provider will likely intensify your treatment with a combination of medications, lifestyle change prescriptions and possibly more frequent contact. An optimal reading of LDL cholesterol is less than 100 mg/dL. You are considered borderline high at 130 mg/dL to 159 mg/dL, high at 160 mg/dL to 189 mg/dL and very high at 190 mg/dL or greater.
Good Cholesterol
When it comes to high-density lipoprotein, or HDL, high is a good thing. HDL's job is to go around collecting LDL to take back to your liver and remove from your body. Some people with "high cholesterol" have low LDL, and some elements of your diet, like trans fats, can lower your HDL. Your HDL is considered high when it's greater than 60 mg/dL, and it's considered low when it's less than 40 mg/dL. Some cholesterol treatments are geared specifically toward improving HDL levels.
Lower Your Cholesterol
Some people are naturally prone to high cholesterol thanks to genetics, but everyone can control some of the risk by eating a healthy diet, getting more physical activity and keeping weight under control. Dietary and lifestyle changes involve radically reducing the amount of saturated fat to 7 percent of your total calories and avoiding trans fats altogether. It also involves decreasing your dietary cholesterol and eating more fiber and plant sterols. The National Heart, Lung and Blood Institute says losing just 10 lbs. if you are overweight could reduce your cholesterol by 5 to 8 percent, and these changes together can reduce your cholesterol 20 to 30 percent. You can also control your risk by quitting smoking. If lifestyle changes aren't enough, your doctor may add one or more cholesterol medications, such as statins, niacin, fibrates and bile-acid resins.
References
- CDC: High Cholesterol: Understand Your Risks
- National Cholesterol Education Program; Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III); May 2001
- American Heart Association: What Your Cholesterol Levels Mean
- Hepatitis A-Z; The Cholesterol Controversy; Mark Johnson
- University of Maryland Medical Center: Cholesterol - Medications
- American Heart Association: Understanding Your Risk for High Cholesterol
