Heart Health: Cholesterol Levels And You

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Keeping your cholesterol levels healthy is a great way to keep your heart healthy – and lower your chances of getting heart disease or having a stroke. Cholesterol can be tricky to understand, though, because not all is bad for you. Some is actually good for you.

The most important thing you can do as a first step is to know your cholesterol numbers by getting your cholesterol tested. Here are some easy ways for you to understand what the testing involves, how it can help you and ways to improve your health by improving your cholesterol.

In order for your doctor to know your cholesterol level, a blood sample must be taken from your finger or your arm. The blood sample will be tested for total cholesterol and HDL cholesterol levels. HDL cholesterol is often called the “good” cholesterol. You don’t have to fast or do anything special before having this blood test done.

After your total cholesterol and HDL levels have been tested, here are some guidelines about what you should do. These guidelines are for people who do not have heart disease.

1. If your total cholesterol is less than 200 mg/dL and your HDL-cholesterol (“good” cholesterol) is 40 mg/dL or greater:

You are doing well and should have your total and HDL-cholesterol levels checked again in about 5 years. In the meantime, take steps to keep your total cholesterol level down; eat foods low in saturated fat and cholesterol, maintain a healthy weight, and be physically active. The last two steps, along with not smoking, will also help keep your HDL level up.

2. If your total cholesterol is less than 200 mg/dL and your HDL cholesterol (“good” cholesterol) less than 40 mg/dL:

You will need a lipoprotein profile to find out your LDL-cholesterol (“bad cholesterol”) level. For this test you need to fast for 9 to 12 hours before the test, have nothing but water, or coffee or tea with no cream or sugar.

3. If your total cholesterol is between 200 to 239 mg/dL and your HDL-cholesterol (“good” cholesterol) is 40 mg./dL or greater:

Your doctor will see if you have other risk factors for heart disease and determine whether more tests (including a lipoprotein profile to find out your LDL-cholesterol) need to be done. No matter what your levels are, it is important to eat foods low in saturated fat and cholesterol and to maintain a healthy diet.
4. If your total cholesterol is 240 mg/dL and above, regardless of your HDL-cholesterol level:

You will need a lipoprotein profile to find out your LDL-cholesterol level. You need to fast for 9 to 12 hours before the test, having nothing but water.

Depending on the results of your total cholesterol and HDL-cholesterol tests, you may also need to have a second blood test called a lipoprotein profile, to determine your LDL-cholesterol. LDL-cholesterol is often called the “bad” cholesterol. For this type of test, your doctor will ask you to fast for 9 to 12 hours before the test. An LDL-cholesterol level test gives your doctor more information about your risk of heart disease and helps guide any necessary treatment.

There are three categories for LDL-cholesterol.

▪ A desirable level is less than 130 mg/dL
▪ A borderline-high risk level is from 130 to 158 mg/dL
▪ High risk is 160 mg/dL and above.

The following guidelines apply to LDL levels for people who do not have heart disease.

If your LDL level is less than 130 mg/dL:

You have a desirable LDL-cholesterol level. You will need to have your total and HDL cholesterol levels tested again in 5 years. You should follow an eating plan low in saturated fat and cholesterol, maintain a healthy weight, be physically active, and not smoke.

If your LDL level is 130 mg/dL or above:

Your doctor will look at your other heart disease risk factors and decide what you need to do to lower your LDL-cholesterol level. The higher your level and the more risk factors you have, the more you need to follow a diet low in saturated fat and cholesterol. For example, if your LDL is 160 mg/dL or greater and you have fewer than two other risk factors, your LDL goal is a level below 160 mg/dL. If your LDL is 130 mg/dL or greater and you have two or more risk factors, your goal is to reduce your LDL level to below 130 mg/dL.

It is also important to lose weight if you are overweight, to be physically active, and to not smoke. Discuss your treatment plan with your doctor.

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