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Understanding Cholesterol Numbers

Medically Reviewed by James Beckerman, MD, FACC on June 18, 2020

Cholesterol levels should be measured at least once every 5 years in everyone over age 20. The screening test that is usually done is a blood test called a lipid profile. Experts recommend that men 35 and older and women 45 and older be screened for lipid disorders more often. The lipoprotein profile includes:

  • Total cholesterol
  • LDL, low-density lipoprotein cholesterol, also called "bad" cholesterol
  • HDL, high-density lipoprotein cholesterol, or "good" cholesterol
  • Triglycerides, fats carried in the blood from the food we eat. Extra calories, alcohol, or sugar are turned into triglycerides and stored in fat cells throughout the body.

Results of your blood test will come in the form of numbers. Here’s how to interpret your cholesterol numbers.

The first thing you need to know is that the numbers by themselves are not enough to predict your risk of heart problems or to determine what you need to do to lower that risk.

They’re just one part of a larger equation that includes your age, your blood pressure, your smoking status, and your use of blood pressure medicines. Your doctor will use this information to calculate your 10-year risk for serious heart problems.

The more risk factors you have, the higher your risk of heart problems and stroke. Taking steps to reduce any of these risks, including lowering cholesterol, may also help reduce other risk factors you have.

Together, you and your doctor will develop a strategy to reduce your risks.

LDL Cholesterol

LDL cholesterol can build up on the walls of your arteries and raise your chances of heart disease. That’s why LDL cholesterol is referred to as "bad" cholesterol. The lower your LDL cholesterol number, the lower your risk.

If your LDL is 190 or more, it is considered very high. Your doctor will most likely recommend a statin in addition to making healthy lifestyle choices. Statins are medicines that can help lower cholesterol levels.

You may also need to take a statin even though your LDL level is lower than 190. After figuring your 10-year risk, your doctor will recommend a percentage by which you should try to lower your LDL level through diet, exercise, and medication if necessary.

HDL Cholesterol

When it comes to HDL cholesterol -- "good" cholesterol -- a higher number means lower risk. This is because HDL cholesterol protects against heart disease by taking the "bad" cholesterol out of your blood and keeping it from building up in your arteries. A statin can slightly increase your HDL, as can exercise.

Triglycerides

Triglycerides are the form in which most fat exists in food and the body. A high triglyceride level has been linked to higher risk of coronary artery disease. Here's the breakdown.

TriglyceridesTriglyceride Category
Less than 150Normal
150 - 199Mildly High
200 - 499High
500 or higherVery high

When you have high triglyceride levels, there's a good chance you also have low levels of HDL "good" cholesterol and high levels of LDL "bad" cholesterol. This combination raises the chance that you’ll have a heart attack or stroke. Here’s good news: Many medications that treat abnormal cholesterol levels also help lower high triglyceride numbers.

Your doctor may recommend that you take additional medications as well, such as pills to lower your blood pressure and your risk of heart disease, stroke, and diabetes. If your triglycerides are very high -- over 500 mg/dL -- you may also get medicine to lower them.

Total Cholesterol

Your total blood cholesterol is a measure of LDL cholesterol, HDL cholesterol, and other lipid components. Your doctor will use your total cholesterol number when determining your risk for heart disease and how best to manage it.

Questions to Ask Your Doctor

If testing shows you have high cholesterol, you may want to ask your doctor these questions at your next visit.

1. What are the dangers of having high cholesterol? Can other problems develop?

2. What could have caused my cholesterol to be too high? Is it inherited?

3. Are there things I can do at home or in my life to reduce my cholesterol?

4. Is medicine necessary? Are there alternative treatments?

5. If medicine is needed, how does the medicine work?

6. How long can I take medicine? What are the side effects? Is long-term use harmful?

7. How can exercise help to lower my cholesterol?

8. Where can I learn more about how to live with high cholesterol?

9. What changes should I make to the way I eat?

10. How often do I need to get my cholesterol level checked?

WebMD Medical Reference

Sources

SOURCES:

Cleveland Clinic: "Heart and Vascular Health & Prevention," "Metabolic Syndrome," The Cleveland Clinic Heart Center.

American Heart Association: "Triglycerides: Frequently Asked Questions," "Triglycerides," "About Metabolic Syndrome."

Talayero, B. Current Cardiology Reports, December 2011.

Palo Alto Medical Foundation, Dietary Guidelines for Reducing Triglycerides."

University of Massachusetts Medical School, "What you can do to lower your triglycerides."

National Heart Lung & Blood Institute, "High Blood Cholesterol: What You Need to Know."

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