Cholesterol: Playing the Numbers Game

When it comes to tracking your heart health, knowing your cholesterol levels is a great place to start.

Health Monitor Staff
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When you hear the word "cholesterol," a lot of numbers may pop into your head. Some people obsess about their total cholesterol number, while others take comfort in having a healthy good cholesterol score. The reality is that most doctors consider four numbers when monitoring cholesterol and other blood lipids.

The four key blood lipid numbers are:

  1. Total cholesterol
  2. Low-density lipoprotein (LDL)
  3. High-density lipoprotein (HDL)
  4. Triglycerides (Trigs)

Cholesterol itself is not bad. In fact, your body needs some of this waxy substance to create cell membranes and hormones, and to protect nerves. Too much cholesterol, however, is a major risk factor for heart disease.

Familiarize yourself with the following terms:

LDL: This is the so-called bad cholesterol. (Remember that "L" stands for "low," and you want this lipid level to be a low number.) LDL shuttles cholesterol through the bloodstream from the liver to the rest of the cells in the body.

HDL: This is the so-called good cholesterol. (The "H" stands for "high." The higher this lipid number, generally speaking, the better your heart health.) HDL drives unused cholesterol from the cells back to the liver, where it's excreted. Any "leftovers" that the HDL can't handle stay in the body and may start collecting in the blood vessels. So, the higher your HDL level is, the more excess cholesterol will get disposed of by the liver, leaving less cholesterol to wreak havoc in your body.

Triglycerides (Trigs): These are fats that provide your body with energy‚ and that's a good thing. But, just like cholesterol, any trigs that are not used for energy remain in the blood. When that happens, trig levels can jump and eventually contribute to hardening of the arteries.

Is your cholesterol too high?
To diagnose high cholesterol, your doctor likely will perform a test called a "fasting lipoprotein profile." The test typically requires you to refrain from eating or drinking anything but water for 9-12 hours before having blood drawn.

Everyone over 20 should get this test every five years. (If you're over 20 and haven't gotten one yet, do it now!) If you are 50 or older, or if you have specific heart-disease risk factors, get tested yearly or as often as your doctor recommends. If you already take medication to treat high cholesterol, your doctor may recommend more frequent blood tests to be sure the medication is doing its job.

When monitoring your blood lipids, you'll need to focus on all four key numbers (total cholesterol, LDL, HDL and triglycerides). Keep in mind that your numbers may vary slightly depending on factors like your overall health and family history. Talk to your doctor about the results of any tests you get.

Cholesterol numbers that matter

Total cholesterol category
Less than 200: Optimal
200 - 239: Borderline high
240 and higher: High

LDL (bad) cholesterol 
Less than 100: Optimal
100 - 129: Near or above optimal
130 - 159: Borderline high
160 - 189: High
190 and higher: Very high

HDL (good) cholesterol
60 and higher: Optimal
Less than 50: Low for women
Less than 40: Low for men

Less than 150: Optimal
150 - 199: Borderline high
200 - 499: High
500 and higher: Very high

October 2010