Cholesterol: What you need to know

Cholesterol is a fat-like substance made by your liver and found in the food you eat.

Cholesterol level goals - Total cholesterol, less than 200 mg/dL – Triglycerides, less than 150 mg/dL - HDL (“good” cholesterol), greater than 40 mg/dL - LDL (“bad” cholesterol), less than 100 mg/dL

Cholesterol screening

Your total cholesterol blood test value has three parts:

HDL, high density lipoprotein, cholesterol is known as the "good" cholesterol.
LDL, low density lipoprotein, cholesterol is known as the "bad" cholesterol.
Triglycerides are fats digested from foods that are released into your bloodstream. It gives your body energy or is stored as fat.

You should have your total cholesterol and HDL checked at age 20. Based on your test results, age and risk factors, your health care provider may recommend more testing. He or she will also tell you how often the test should be repeated. If total cholesterol/HDL screening comes back as "abnormal," you may need to have a complete fasting lipid profile. This profile will check your total cholesterol, HDL, LDL and triglycerides.

The importance of LDL and HDL

When too much LDL ("bad" cholesterol) builds up on your artery walls, plaque forms and blocks blood flow in vessels leading to your heart, legs and brain. This can cause heart disease, peripheral artery disease and strokes.

The National Cholesterol Education Program guidelines for LDL cholesterol levels are:

optimal: less than 100 mg/dL
near optimal: 100 to 129 mg/dL
borderline high: 130 to 159 mg/dL
high: 160 to 189 mg/dL
very high: 190 mg/dL and higher.

HDL ("good" cholesterol) helps to get rid of extra cholesterol from your blood and tissues. Higher levels of HDL may prevent or reverse blood vessel problems.

The National Cholesterol Education Program guidelines for HDL cholesterol levels are:

40 mg/dL or higher for men
50 mg/dL or higher for women.

How cholesterol is linked to heart disease

Certain things can put your heart at risk. These include age, family history of heart disease, high blood pressure, low HDL and other risks such as smoking.

Having a low HDL and a high LDL means that plaque on your artery walls does not break up. When the plaque blocks blood flow to your heart, you may have a heart attack.

Heart disease risk factors

You may develop heart disease if you have any of these risk factors:

low HDL cholesterol (less than 40 mg/dL)
cigarette smoking
high blood pressure
diabetes
age and gender

men age 45 and older
women age 55 and older or women who had early menopause without hormone therapy

family history of heart disease

father or close male relatives younger than age 55
mother or close female relative younger than age 65

How to improve your cholesterol

To boost your HDL ("good" cholesterol) and lower your LDL ("bad" cholesterol), the National Cholesterol Education Program offers these tips:

To increase HDL…

Lose weight if you are overweight. (What's your ideal weight?)
Stop smoking if you smoke.
Exercise and weight loss.

To decrease LDL…

Lose weight if you are overweight. (What's your ideal weight?)
Lower the saturated fat and cholesterol in your diet. (Try our diet low in saturated fat and cholesterol.)
Add more fiber to your diet.