The American Heart Association recommends, starting at the age of 20, that all Americans have a cholesterol test, otherwise called a fasting lipoprotein panel, every five years. A fasting lipoprotein panel, performed through a blood test, provides four measurements -- your total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride levels. Using these measurements, you can calculate your cholesterol ratios, providing information that you and your health care provider can use to help asses your risk of developing heart disease.
Cholesterol
Cholesterol is a waxy, fat-like substance that your body needs in small amounts to function properly. Approximately 75 percent of your total blood cholesterol is produced by your body in your liver and other cells, and the other 25 percent is made up of the cholesterol found in animal products you consume. Excess cholesterol in your blood can build up on the walls of your arteries, forming plaque, which narrows and potentially blocks your arteries. High cholesterol increases your risk of suffering heart disease, heart attack and stroke.
HDL and LDL Cholesterol
Cholesterol is not easily mixed with your blood due to its waxy, fat-like nature, therefore to transport it to where it is needed, your body coats it with water-soluble proteins to form lipoproteins. HDL, or high-density lipoprotein, cholesterol is considered the good cholesterol because it is primarily made up of protein, with only small amounts of cholesterol, and works to remove cholesterol from the walls of your arteries, helping to protect you from heart attack and stroke. LDL, or low-density lipoprotein, cholesterol is considered the bad cholesterol, as it is primarily made up of cholesterol, containing only small amounts of protein, and deposits cholesterol on your artery walls, increasing your risk of heart attack and stroke.
Cholesterol Ratios
The most commonly considered cholesterol ratio is total cholesterol measured against HDL cholesterol. To calculate, divide your HDL cholesterol into your total cholesterol. For example, with a total cholesterol level of 200 mg/dL and an HDL cholesterol of 50 mg/dL, your ratio is 4 to 1. The lower the ratio, the lower your risk of developing heart disease. The Mayo Clinic recommends that you aim to keep your ratio below 4 to 1. Your LDL to HDL ratio is calculated in the same way; a ratio of less than 3 to 5 is recommended, with 2 to 5 being ideal.
Cholesterol Levels
Cholesterol ratios may be useful for assessing your risk of heart disease, but to determine treatment options, the American Heart Association recommends using your absolute cholesterol levels rather than cholesterol ratios. This is because your heart disease risk is affected by both your HDL cholesterol and LDL cholesterol, and treatment may be aimed at improving both of these levels. To understand your cholesterol level health, the ideal level of total cholesterol is less than 200 mg/dL, the optimal LDL cholesterol level is below 100 mg/dL and an HDL cholesterol level above 60 mg/dL is considered protective against heart disease.
References
- American Heart Association: What Your Cholesterol Levels Mean
- Mayo Clinic; High Cholesterol: How Important Is Cholesterol Ratio; Thomas Behrenbeck, M.D., Ph.D., June 8, 2010
- Medline Plus: Cholesterol
- American Heart Association: About Cholesterol
- University of Maryland Medical Center: Types of Cholesterol
- HealthCentral.com; Making Sense of Cholesterol Ratios, Lipid Profiles and Your Heart Disease Risk Scores; Lisa Nelson, RD, LN, September 8, 2008
