If you’re 20 years old or older, your doctor has probably recommended that you have your blood tested to check your cholesterol. When you look at your lab results, you’ll see a lot of different measurements, acronyms and ratios. What does it all mean? How can you make sense of it? And what can you do with all this information?
We talked to Cecilia Hirsch, MD, a cardiologist at the CardioVascular Institute of North Colorado Cardiology Clinic in Greeley CO, to learn more about what cholesterol is, exactly, and why it matters.
What is cholesterol?
Cholesterol is a waxy substance your body needs to build cells. Your liver generates cholesterol, and it can produce all the cholesterol your body requires. Too much cholesterol can be bad for your heart.
“When cholesterol builds up in your blood vessels, they can become narrower and less flexible,” Dr. Hirsch said. If a blood clot forms in a narrow artery, it can trigger a heart attack or stroke. So, having too much bad cholesterol or not enough good cholesterol can increase your risk of these serious health problems.
When you eat foods that are high in saturated fats, trans fats or oils such as palm oil and coconut oil, your liver produces more cholesterol than it normally would. Eating these foods can push your cholesterol levels from healthy to unhealthy. In addition, some foods, including meat, poultry and full-fat dairy products, contain dietary cholesterol. Eating them can affect the overall cholesterol levels in your body.
You’ve probably heard that high cholesterol is bad and low cholesterol is good. That’s generally true, but it’s a bit of an oversimplification. When you know more about the different types of cholesterol, how cholesterol levels are calculated and what they mean, you can take steps to make sure your levels are in the right range and to keep your heart healthy.
What are LDL and HDL cholesterol?
When people talk about good cholesterol and bad cholesterol, they are referring to low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL is the “bad” cholesterol since it increases your risk for heart disease. HDL is the “good” cholesterol since it lowers your risk of heart disease.
What are triglycerides?
Triglycerides are a type of fat that your body uses to store energy from the food you eat. They are the most common type of fat found in your body. “About one-quarter of U.S. adults have high triglyceride levels,” Dr. Hirsch said. High levels of triglycerides along with high LDL cholesterol and low HDL cholesterol levels are linked to fatty buildups in the artery walls and a higher risk of heart disease.
What are the recommended cholesterol levels?
Your doctor will probably want to see your cholesterol scores in these ranges:
- Total cholesterol: < 200 mg/dL (calculated as your HDL + LDL + 20% triglycerides)
- LDL cholesterol: < 100 mg/dL
- HDL cholesterol: > 60 mg/dL
- Triglycerides: < 150 mg/dL
Your doctor may also calculate your cholesterol ratio, which is your total cholesterol divided by your HDL cholesterol. A higher ratio means you have a higher risk for heart disease. Your doctor will probably want your ratio to be below 5, and below 3.5 is very good.
When should you have your cholesterol levels checked?
The American Heart Association recommends that all adults 20 years of age and older have their cholesterol levels checked every four to six years as long as the risk of heart attack or stroke stays low. After age 40 your doctor will calculate your risk and recommend the best timeframe for screening.
How can lifestyle changes make your cholesterol levels healthier?
These lifestyle changes can help you improve your cholesterol levels and reduce your risk factors for heart disease:
- Choose a diet low in fat and refined carbohydrates.
- Eat fish with high amounts of omega-3 fatty acids, such as salmon, tuna, halibut, anchovies, mussels and oysters.
- Exercise for 30 minutes a day, five to six days per week.
- Maintain a healthy body weight.
- Don’t smoke.
- Limit alcoholic drinks to one per day for women and two per day for men.
- Take any prescribed medications for your blood pressure and heart.
How can medication help improve your cholesterol levels?
Lifestyle changes can’t always get your cholesterol numbers into healthy ranges. You may also need to take statins, a type of drug that can help lower your LDL levels.
When you have your cholesterol tested, your doctor can calculate your risk of having a heart attack or other cardiovascular event within the next 10 years. If your risk is high, your doctor will most likely recommend statins to reduce your cholesterol levels. Statins can reduce your risk of cardiovascular problems by 20 to 25% and the higher your risk the more benefit you are likely to gain.
“There is no definitive treatment that’s right for everyone,” Dr. Hirsch said. “Your doctor can help you evaluate your risk and preferences and decide what’s right.”
The bottom line
Your cholesterol levels, which include total cholesterol, LDL and HDL cholesterol and triglycerides, give you crucial information about your risk for heart disease. When you know these numbers and understand what they mean, you can find ways to improve them and keep your heart healthier.
Other useful articles
- 3 Foods High in Cholesterol but Good for Your Health
- What a Cardiologist Wants You to Know About the New Heart-Healthy Diet Guidelines
- Get “the Skinny” on Fats: The Good, the Bad and the Worst for You