EVERYTHING YOU NEED TO KNOW ABOUT CHOLESTEROL

19190Know Your Cholesterol Levels Lately?

You’ve heard of good cholesterol (HDL) and bad cholesterol (LDL) but what does it all mean? High blood pressure and cholesterol — two factors that contribute to heart disease. Knowing what your LDL levels are can help you make more informed lifestyle decisions.

 

Get Your Cholesterol Checked

Too much cholesterol (“koh-LEHS-tuh-rahl”) in your blood can cause a heart attack or a stroke. You could have high cholesterol and not know it.

The good news is that it’s easy to get your cholesterol checked – and if your cholesterol is high, you can take steps to control it.

Who needs to get their cholesterol checked?

  • All men age 35 and older
  • Men ages 20 to 35 who have heart disease or risk factors for heart disease
  • Women age 20 and older who have heart disease or risk factors for heart disease

Talk to your doctor or nurse about your risk factors for heart disease. Ask if you need to get your cholesterol checked.

What are the risk factors for heart disease?
Risk factors for heart disease include:

  • High blood pressure
  • A family history of heart disease
  • Hardening of the arteries (called atherosclerosis)
  • Smoking
  • Diabetes
  • Being overweight or obese
  • Not getting enough physical activity

What is cholesterol?
Cholesterol is a waxy substance (material) that’s found naturally in your blood. Your body makes cholesterol and uses it to do important things, like making hormones and digesting fatty foods.

You also get cholesterol by eating foods like egg yolks, fatty meats, and regular cheese.

If you have too much cholesterol in your body, it can build up inside your blood vessels and make it hard for blood to flow through them. Over time, this can lead to a heart attack or a stroke.

What are the symptoms of high cholesterol?
There are no signs or symptoms of high cholesterol. That’s why it’s so important to get your cholesterol checked.

How often do I need to get my cholesterol checked?
The general recommendation is to get your cholesterol checked every 5 years. Some people need to get their cholesterol checked more or less often. Talk to your doctor about what’s best for you.

How can I get my cholesterol checked?
Cholesterol is checked with a blood test called a lipid profile. During the test, a nurse will take a small sample of blood from your finger or arm.

Be sure to find out how to get ready for the test. For example, you may need to fast (not eat or drink anything except water) for 9 to 12 hours before the test.

What do the test results mean?
If you get a lipid profile test, the results will show 4 numbers. A lipid profile measures:

  • Total cholesterol
  • HDL (good) cholesterol
  • LDL (bad) cholesterol
  • Triglycerides (“try-GLIH-suh-rydz”)

Total cholesterol is a measure of all the cholesterol in your blood. It’s based on the HDL, LDL, and triglycerides numbers.

HDL cholesterol is the good type of cholesterol – so a higher level is better for you. Having a low HDL cholesterol level can increase your risk for heart disease.

LDL cholesterol is the bad type of cholesterol that can block your arteries – so a lower level is better for you.

Triglycerides are a type of fat in your blood that can increase your risk for heart attack and stroke.

What can cause unhealthy cholesterol levels?
Causes of unhealthy HDL cholesterol levels include:

  • Genetic (inherited) factors
  • Type 2 diabetes
  • Smoking
  • Being overweight
  • Not getting enough physical activity
  • Taking certain medicines

Causes of unhealthy LDL cholesterol levels include:

  • Having a family history of high LDL cholesterol
  • Eating too much saturated fat, trans fat, and cholesterol

What if my cholesterol levels aren’t healthy?
As your LDL cholesterol gets higher, so does your risk of heart disease. Take these steps to lower your cholesterol and reduce your risk of heart disease:

  • Eat heart-healthy foods.
  • Get active.
  • If you smoke, quit.

Ask your doctor if you also need to take medicine to help lower your cholesterol.

 

Cholesterol testing and results

Cholesterol is a soft, wax-like substance found in all parts of the body. Your body needs a little bit of cholesterol to work properly. But too much cholesterol can clog your arteries and lead to heart disease.

Cholesterol blood tests are done to help you and your health care provider better understand your risk for heart disease, stroke, and other problems caused by narrowed or blocked arteries.

The ideal values for all cholesterol results depend on whether you have heart disease, diabetes, or other risk factors. Your provider can tell you what your goal should be.

Cholesterol Tests
Some cholesterol is considered good and some is considered bad. Different blood tests can be done to measure each type of cholesterol.

Your provider may order only a total cholesterol level as the first test. It measures all types of cholesterol in your blood.

You may also have a lipid (or coronary risk) profile, which includes:

  • Total cholesterol
  • Low density lipoprotein (LDL cholesterol)
  • High density lipoprotein (HDL cholesterol)
  • Triglycerides (another type of fat in your blood)
  • Very low density lipoprotein (VLDL cholesterol)

Lipoproteins are made of fat and protein. They carry cholesterol, triglycerides, and other fats, called lipids, in the blood to various parts of the body.

When Should You Be Tested?
Everyone should have their first screening test by age 35 for men, and age 45 for women. Some guidelines recommend starting at age 20.

You should have a cholesterol test done at an earlier age if you have:

  • Diabetes
  • Heart disease
  • Stroke
  • High blood pressure
  • A strong family history of heart disease

Follow-up testing should be done:

  • Every 5 years if your results were normal
  • More often for people with diabetes, high blood pressure, heart disease, stroke, or blood flow problems to the legs or feet
  • Every year or so if you are taking medicines to control high cholesterol

Total Cholesterol
A total cholesterol of 180 to 200 mg/dL or less is considered best.

You may not need more cholesterol tests if your cholesterol is in this normal range.

LDL (Bad) Cholesterol
LDL cholesterol is sometimes called “bad” cholesterol. LDL can clog your arteries.
You want your LDL to be low. Too much LDL is linked to heart disease and stroke.
Your LDL is most often considered to be too high if it is 190 mg/dL or higher.

Levels between 70 and 189 mg/dL are most often considered too high if:

  • You have diabetes and are between ages 40 and 75
  • You have diabetes and a high risk of heart disease
  • You have a medium or high risk of heart disease

Health care providers have traditionally set a target level for your LDL cholesterol if you are being treated with medicines to lower your cholesterol.

  • Some newer guidelines now suggest that providers no longer need to target a specific number for your LDL cholesterol. Higher strength medicines are used for the highest risk patients.
  • However, some guidelines still recommend using specific targets.

HDL (Good) Cholesterol
You want your HDL cholesterol to be high. Studies of both men and women have shown that the higher your HDL, the lower your risk of coronary artery disease. This is why HDL is sometimes referred to as “good” cholesterol.

HDL cholesterol levels greater than 40 to 60 mg/dL are desired.

VLDL (Bad) Cholesterol
VLDL contains the highest amount of triglycerides. VLDL is considered a type of bad cholesterol, because it helps cholesterol build up on the walls of arteries.

Normal VLDL levels are from 2 to 30 mg/dL.

Considerations
Sometimes, your cholesterol levels may be low enough that your provider will not ask you to change your diet or take any medicines.

Alternate Names
Cholesterol test results; LDL test results; VLDL test results; HDL test results; Coronary risk profile results; Hyperlipidemia-results; Lipid disorder test results

 

Take Action!

Find out what your cholesterol levels are. If your cholesterol is high, take steps to control it.

Make an appointment to get your cholesterol checked.
Call your doctor’s office or health center to schedule the test. Be sure to ask for a complete lipid profile – and find out what instructions you’ll need to follow before the test. For example, you may need to fast (not eat or drink anything except water) for 9 to 12 hours before the test.

Eat heart-healthy foods.
Making healthy changes to your diet can help lower your cholesterol. Try to:

  • Eat less saturated fat, which comes from animal products (like regular cheese, fatty meats, and dairy desserts) and tropical oils (like palm, palm kernel, and coconut oil).
  • Stay away from trans fats, which may be in baked goods (like cookies and cake), snack foods (like microwave popcorn), fried foods, and margarines.
  • Limit foods that are high in cholesterol, including fatty meats and organ meat (like liver and kidney).
  • Limit foods that are high in salt or added sugar.
  • Choose low-fat or fat-free milk, cheese, and yogurt.
  • Eat more foods that are high in fiber, like oatmeal, oat bran, beans, and lentils.
  • Eat more vegetables and fruits.

To be healthy, your body needs to get enough vitamins, minerals, and other nutrients. Eating healthy means getting plenty of:

  • Vegetables, fruits, whole grains, and fat-free or low-fat milk products
  • Seafood, lean meats and poultry, eggs, beans, peas, seeds, and nuts

Eating healthy also means limiting:

  • Cholesterol, sodium (salt), and added sugars
  • Trans fats, which may be in foods like cakes, cookies, stick margarines, and fried foods
  • Saturated fats, which come from animal products like cheese, fatty meats, whole milk, and butter
  • Foods made with refined grains, like white bread, noodles, white rice, and flour tortillas

Get active.
Getting active can help you lose weight, lower your LDL (bad) cholesterol, and raise your HDL (good) cholesterol. Aim for 2 hours and 30 minutes a week of moderate activity, such as:

  • Walking fast
  • Swimming
  • Aerobics

Get more tips on protecting your heart with physical activity [PDF – 426 KB].

Quit smoking.
Quitting smoking will help lower your cholesterol. If you smoke, make a plan to quit today. Call 1-800-QUIT-NOW (1-800-784-8669) for free support and to set up your quit plan.

And if you don’t smoke, don’t start!

 

 


 

References

American Diabetes Association. Standards of medical care in diabetes – 2014.Diabetes Care.

Gennest J, Libby P. Lipoprotein disorders and cardiovascular disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds.Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine.

Pencina MJ, Navar-Boggan AM, D’Agostino RB Sr, Williams K, Neely B, Sniderman AD, Peterson ED. Application of new cholesterol guidelines to a population-based sample.N Engl J Med http://www.ncbi.nlm.nih.gov/pubmed/24645848

Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults.J Am Coll Cardiol.http://www.ncbi.nlm.nih.gov/pubmed/24239923

Stone NJ, Robinson JG, Lichtenstein AH, Goff DC Jr, Lloyd-Jones DM, Smith SC Jr, et al. Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: Synopsis of the 2013 American College of Cardiology/American Heart Association cholesterol guideline.Ann Intern Med.

Update Date 11/26/2014

Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

Get Your Cholesterol Checked 
Content last updated on: August 27, 2015
Office of Disease Prevention and Health Promotion
U.S. Department of Health and Human Services
healthypeople.gov

Share This Post