You knew about good and bad cholesterol even before you had a blood test, but the numbers can seem a jumble when you're facing them. There are individual components plus totals. So just what are normal blood test results for cholesterol, and when should you be concerned?
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According to the American Heart Association (AHA), the best test for checking all your numbers is a lipid profile. It measures all the blood fats and gives results in milligrams per deciliter of blood. These numbers are all important on their own and in relation to each other.
LDL Cholesterol Explained
Low-density lipoprotein (LDL) cholesterol is the bad cholesterol. Blood fat, or "lipids" need proteins to move through the blood, explains the U.S. National Library of Medicine. High LDL levels can lead to a buildup of cholesterol on the walls of your arteries, where it can help form the narrowing plaques that block blood flow and lead to strokes and heart attacks, according to the Cleveland Clinic.
"Your LDL numbers are important for deciding if you need to be on a statin drug to lower cholesterol," says Neel L. Shah, MD, an associate professor of endocrinology at McGovern Medical School at UTHealth in Houston. "To make this decision, doctors will look at your age and risk factors along with your LDL numbers."
According to the Cleveland Clinic, these are the numbers you need to know for LDL cholesterol:
- Best: Less than 100 milligrams per deciliter
- Good: 100 to 129
- Borderline: 130 to 159
- High: 160 to 189
- Very high: 190 or above
HDL Cholesterol Explained
High-density lipoprotein (HDL) cholesterol is the good cholesterol because this protein carries cholesterol out of your blood and away from your arteries into your liver. While you want your LDL to be low, you want your HDL to be high. According to the Cleveland Clinic, if your HDL is above 60 milligrams per deciliter, your number is good. If the number is below 40, you may be at increased risk for cardiovascular disease.
What Are Triglycerides?
Triglycerides are the form in which most fats exist in foods and in your body, explains the Cleveland Clinic. High levels of triglycerides have been linked to an increased risk for heart disease. These are the numbers to know:
- Normal: Less than 150 milligrams per deciliter
- Borderline: 150 to 199
- High: 200 to 499
- Very high: 500 or higher
Weighing Good and Bad Cholesterol
Total cholesterol is a measurement of all three types of lipoproteins — LDL, HDL and 20 percent of your triglycerides, explains the AHA. But it is no longer considered the most important number.
"In the past, doctors looked at total cholesterol and the ratio between HDL and LDL to predict cardiovascular risk," says Dr. Shah. "The problem with total cholesterol is that you could have a total under 200 with a low HDL, which would still put you at risk. Today the cholesterol number that is most important is non-HDL cholesterol."
Non-HDL cholesterol is total cholesterol minus your good HDL number. "This number is now included in most lipid profile blood tests," says Dr. Shah. According to the Mayo Clinic, the goal for non-HDL cholesterol is less than 130 milligrams per deciliter.
Read more: The Ideal Ratio of Total Cholesterol to HDL
Fasting for Your Blood Test
Fasting before your test is very important to get accurate numbers. For example, eating a high-fat meal can shoot your triglyceride numbers up by 30 percent. Alcohol can also cause a triglyceride surge. "The usual instruction is nothing to eat or drink for at least eight hours before the test," says Dr. Shah. "However, a high-fat meal before starting your fast may still affect your numbers, and you should avoid alcohol for 24 hours."
The Bottom Line
Your cholesterol numbers are only one part of your cardiovascular risk, notes the AHA. Other risk factors include things you can't control, like your age and family history.
But there also are many factors that you can control, like smoking, your blood pressure, your weight, physical activity level and your diet. Use your cholesterol tests results to work with your doctor on a plan to control these risk factors to keep or get your cholesterol numbers in a healthy range and protect your heart health.
Is This an Emergency?
- American Heart Association: "What Your Cholesterol Numbers Mean"
- Mayo Clinic: "Cholesterol Ratio or Non-HDL Cholesterol?"
- Cleveland Clinic: "Cholesterol Numbers: What Do They Mean?"
- Neel L. Shah, MD, associate professor of endocrinology, McGovern Medical School, UTHealth, Houston
- U.S. National Library of Medicine: "LDL: The Bad Cholesterol"