Cholesterol

Your cholesterol levels are important because they help you know your risk for heart disease. Cholesterol is a type of lipid (fat) that helps your body perform many important functions. But too much cholesterol in your blood is harmful. It can enter your artery wall, weaken it and lead to atherosclerotic plaque (hardened deposits) forming.

This process of plaque buildup is called atherosclerosis. It can lead to serious problems like:

• Coronary artery disease: Blocked blood flow to your heart
• Peripheral artery disease: Blocked blood flow to your legs and arms
• Carotid artery disease: Blocked blood flow to your brain

You can live for many years with high cholesterol and not even know it. That’s why it’s essential to get your cholesterol numbers checked on a regular basis. If your cholesterol numbers are too high (hyperlipidemia), that’s a red flag for you and your healthcare provider, and it may place you at risk of a heart attack or stroke.

Many people have high cholesterol, which is a major risk factor for heart disease. But you’re not stuck with the cholesterol numbers you have. It’s possible to change them by tweaking some habits and maybe taking some medicines. The first step is learning what your numbers are. Then, you can work with your healthcare provider to reach healthier numbers if needed.

The main levels your healthcare provider checks are:

• Total cholesterol: This is the total amount of cholesterol that’s hanging out in your blood.
• LDL (low-density lipoprotein): This is the “bad” cholesterol that, in excess, contributes to plaque buildup in your arteries.
• VLDL (very-low density lipoprotein): This is another type of cholesterol that’s “bad” when you have too much of it.
• HDL (high-density lipoprotein): This is the “good” cholesterol that helps clear out the bad stuff your body doesn’t need.

Your provider checks your cholesterol levels with a blood test they call a lipid panel or profile. They also measure your triglycerides (another type of fat) at the same time. A provider will draw blood from a vein in your arm and send it to a lab for analysis.

Be sure to follow your provider’s instructions on how to prepare for the test. You’ll likely need to fast for 12 hours beforehand. This means avoiding all foods and drinks except water.

When your results come in, your provider will let you know. You may also be able to access your results through your electronic medical record. The results will show your cholesterol levels as milligrams of cholesterol per deciliter of blood. This is abbreviated as mg/dL.

Normal cholesterol levels vary based on your age, ethnicity and sex. Here are numbers that healthcare providers consider normal for most adults. Generally speaking, though, low levels of total cholesterol and LDL cholesterol are considered better:

• Total cholesterol: Below 200
• LDL cholesterol: Below 100
• VLDL cholesterol: Below 30
• HDL cholesterol: 40-80 (males), 50-80 (females)

Here are a few things to know about these levels:

• If you have heart disease or many risk factors, your LDL target may be different. Your healthcare provider may want it to be below 70.
• Your HDL is the one number providers like to see higher, not lower. Ideally, your HDL should be between 60 and 80 to protect you against heart disease. An HDL over 80 is too high and may not be healthy for you.
• Your HDL is also the only number that has sex-based differences. Females need a higher HDL level than males.

High cholesterol generally means your total cholesterol is 200 mg/dL or higher, or higher than normal. But providers also use terms like “borderline high” to break down your results. If your numbers are close to normal, they may be easier to manage.

Here are the high cholesterol numbers to know:

Total cholesterol:

• Borderline high: 200-239
• High: 240 or higher

LDL cholesterol:

• Elevated: 100-129
• Borderline high: 130-159
• High: 160-189
• Very high: 190 or higher

VLDL cholesterol:

• 30 or higher

Can cholesterol levels be too low?

For LDL, VLDL and total cholesterol, lower is better — typically as low as you can go. Researchers haven’t set a lower limit for these. But your HDL is unique. It needs to be higher, rather than lower. It shouldn’t fall below 40 (in males) or 50 (in females).