Cholesterol Levels:

What Do The Numbers Mean?

Cholesterol Numbers Matter

Cholesterol levels matter because coronary heart disease matters. 

Coronary heart disease is the number killer of men and women in the US and other developed countries. It can lead to…

  • Angina – chest pains which can be quite painful.
  • Myocardial infarction – heart attack due to irreversible heart muscle damage.
  • Congestive heart failure – a condition in which the heart cannot effectively supply the rest of the body with blood.
  • Arrhythmia – irregular heart rate which can lead to sudden cardiac death.
  • Stroke

… to mention some of the more serious conditions. High cholesterol is a major risk factor for coronary heart disease. If your cholesterol levels are high you are at increased risk for developing heart disease.

What is Important to Know?

A lipoprotein profile includes…

  • Total serum cholesterol
  • HDL cholesterol
  • LDL cholesterol
  • Triglycerides

Cholesterol levels are not the only important consideration in evaluating risk for coronary heart disease. Triglyceride levels are becoming increasingly important. Research has shown that high triglycerides are an independent risk factor for coronary heart disease. Therefore it is important to include information on triglyceride levels here.

What Do The Numbers Indicate?

Evaluating risk for heart disease is more complicated than looking at charts on cholesterol levels and triglycerides. Proper evaluation requires a consideration of other risk factors for developing heart disease. Your doctor will take these other risk factors into account when setting goals for you. You can, however, use this link to read more on evaluating risk and LDL cholesterol

For now we will have to content ourselves with more general considerations. 

When you receive your lipoprotein test results you will see your cholesterol levels and triglyceride levels in milligrams per deciliter of blood (mg/dL). The charts below will help you understand what these numbers mean.


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Total Cholesterol Numbers

Assuming no other risk factors - and your LDL and HDL are within acceptable ranges - your total blood cholesterol should be below 200 mg/dL. Such a scenario indicates that you have a low risk of developing coronary heart disease and the other chronic conditions that can develop from it.

Total Cholesterol

Below 200 mg/dL Desirable (lower risk for heart disease)
200-239 mg/dL Borderline high
Above 239 mg/dL High (more than 2x risk for heart disease)

If your total cholesterol levels fall within the borderline high range then your doctor will evaluate other risk factors including HDL, LDL, and triglyceride levels. If these are all within optimal ranges your doctor will most likely recommend lifestyle modifications rather than medication. 

If other risk factors are present your doctor may prescribe medication in addition to lifestyle modifications.

HDL Cholesterol Levels

HDL is the good cholesterol. Higher levels of HDL help prevent the development of atherosclerosis and, therefore, coronary heart disease. If you are a man and have HDL levels below 40 mg/dL then you are at higher risk for heart disease. For women the level is 50 mg/dL.

HDL Cholesterol

Below 40 mg/dL Poor (for men - major risk for heart disease)
Below 50 mg/dL Poor (for women - major risk for heart disease)
40-59 mg/dL Better
Above 59 mg/dL Best

HDL cholesterol levels can be increased by medications. Lifestyle modifications can also affect HDL levels. For example…

  • Don’t smoke
  • Keep off the extra pounds
  • Get plenty of exercise

Also, people with high triglycerides usually have lower HDL levels.

Triglyceride levels respond well to certain dietary adjustments. Triglycerides can also be lowered by supplementing with Omega-3.

LDL Cholesterol Levels

Of course LDL is the bad cholesterol. LDL levels are considered a better gauge of heart disease risk than total cholesterol. If your LDL is high you are at increased risk for developing heart disease.

LDL Cholesterol

Below 70 mg/dL Optimal for people at highest risk for heart disease
Below 100 mg/dL Optimal for people at elevated risk for heart disease
100-129 mg/dL Near optimal
130-159 mg/dL Borderline high
160-189 mg/dL High
Above 189 mg/dL Very high

Much research has indicated that it isn’t merely the levels of LDL that promote heart disease. Rather it is the oxidation of LDL cholesterol that promotes coronary heart disease. A diet high in antioxidants, therefore, is an important safeguard against atherosclerosis development.

Triglyceride Levels

As mentioned, triglyceride levels indicate an independent risk factor for heart disease. That means if your cholesterol levels are normal but your triglycerides are high you are still at higher risk for developing heart disease. 

And as also mentioned above, people with high triglycerides also tend to have low HDL levels. This presents a double problem. If your triglycerides are high it is important to get them down.

Triglycerides

Below 150 mg/dL Desirable
150-199 mg/dL Borderline high
200-499 mg/dL High
Above 499 mg/dL Very high

For most people, triglycerides respond well to dietary changes. You can learn more about this in the triglycerides section

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