Cholesterol , triglyceride , HDL , LDL
What Do My Cholesterol
high blood cholesterol
signals a higher risk of heart attack, its important to have
your cholesterol levels checked regularly and discuss them with
your doctor. Your doctor will test your total cholesterol and HDL-cholesterol
and will tell you about these readings. You may also ask your
doctor to tell you about your LDL and triglyceride readings, if
these were taken.
Taking a small blood sample
from a finger is one common way that cholesterol levels can be
What should my total
cholesterol level be?
Total Blood Cholesterol Levels:
(mg/dL means milligrams per deciliter of blood)
than 200 mg/dL
that puts you at lower risk for heart disease. A
cholesterol level of 200 mg/dL or higher raises your risk.
mg/dL and above
cholesterol. A person with this level has more than twice
the risk of heart disease as someone whose cholesterol is
below 200 mg/dL.
What should my HDL-cholesterol
HDL stands for high density lipoprotein. HDL is considered
"good" cholesterol because it seems to protect you from
heart attack. That means that unlike other cholesterol levels the
higher your HDL, the better.
You can raise your HDL by
quitting smoking, losing excess weight and being more active.
Drinking alcohol also helps raise HDL, but since alcohol can cause
other problems, don't start drinking or drink more to raise your
HDL. Make healthy lifestyle changes to raise your HDL and reduce
your risk of heart attack.
HDL Cholesterol Levels:
(milligrams per deciliter of blood = mg/dL)
than 40 mg/dL
major risk factor for heart disease.
The higher your HDL
level, the better.
mg/dL and above
HDL of 60 mg/dL and above is considered protective against
What should my LDL-cholesterol
LDL stands for low-density lipoprotein. This is the main
carrier of harmful cholesterol in your blood. A high level of LDL
means there's a higher risk of heart disease.
LDL Cholesterol Levels:
(milligrams per deciliter of blood = mg/dL)
than 100 mg/dL
Near or above
mg/dL and above
What should my
triglyceride level be?
Most of your body fat comes in the form of triglycerides.
Butter, margarine and vegetable oil are triglycerides, too. High
triglyceride levels can result from being overweight, drinking a
lot of alcohol, or having diabetes or other disorders. Its no
clear yet whether triglycerides are a risk factor for heart
disease or not.
than 150 mg/dL
My Cholesterol and
Use the chart below to keep track of your cholesterol and
triglyceride levels each time you have a test. Make sure you
discuss these numbers with your doctor.
blood cholesterol level
than 100 mg/dL if you have had a heart attack.
How can I learn more?
- If you have heart
disease, members of your family also may be at higher risk.
It's very important for them to make changes now to lower
When there is too much
cholesterol (a fat-like substance) in your blood, it builds up in
the walls of your arteries. Over time, this buildup causes
"hardening of the arteries" so that arteries become
narrowed and blood flow to the heart is slowed down or blocked.
The blood carries oxygen to the heart, and if enough blood and
oxygen cannot reach your heart, you may suffer chest pain. If the
blood supply to a portion of the heart is completely cut off by a
blockage, the result is a heart attack.
High blood cholesterol
itself does not cause symptoms, so many people are unaware that
their cholesterol level is too high. It is important to find out
what your cholesterol numbers are because lowering cholesterol
levels that are too high lessens the risk for developing heart
disease and reduces the chance of a heart attack or dying of heart
disease, even if you already have it. Cholesterol lowering is
important for everyone--younger, middle age, and older adults;
women and men; and people with or without heart disease.
Everyone age 20 and older
should have their cholesterol measured at least once every 5
years. It is best to have a blood test called a "lipoprotein
profile" to find out your cholesterol numbers. This blood
test is done after a 9- to 12-hour fast and gives information
- Total cholesterol
- LDL (bad)
cholesterol--the main source of cholesterol buildup and
blockage in the arteries
- HDL (good)
cholesterol--helps keep cholesterol from building up in the
form of fat in your blood
If it is not possible to
get a lipoprotein profile done, knowing your total cholesterol and
HDL cholesterol can give you a general idea about your cholesterol
levels. If your total cholesterol is 200 mg/dL* or more or if your
HDL is less than 40 mg/dL, you will need to have a lipoprotein
profile done. See how your cholesterol numbers compare to the
than 200 mg/dL
mg/dL and above
* Cholesterol levels are
measured in milligrams (mg) of cholesterol per deciliter (dL) of
than 100 mg/dL
mg/dL and above
HDL (good) cholesterol
protects against heart disease, so for HDL, higher numbers are
better. A level less than 40 mg/dL is low and is considered a
major risk factor because it increases your risk for developing
heart disease. HDL levels of 60 mg/dL or more help to lower your
risk for heart disease.
Triglycerides can also
raise heart disease risk. Levels that are borderline high (150-199
mg/dL) or high (200 mg/dL or more) may need treatment in some
A variety of things can
affect cholesterol levels. These are things you can do something
fat and cholesterol in the food you eat make your blood
cholesterol level go up. Saturated fat is the main culprit, but
cholesterol in foods also matters. Reducing the amount of
saturated fat and cholesterol in your diet helps lower your
blood cholesterol level.
overweight is a risk factor for heart disease. It also tends to
increase your cholesterol. Losing weight can help lower your LDL
and total cholesterol levels, as well as raise your HDL and
lower your triglyceride levels.
Not being physically active is a risk factor for heart disease.
Regular physical activity can help lower LDL (bad) cholesterol
and raise HDL (good) cholesterol levels. It also helps you lose
weight. You should try to be physically active for 30 minutes on
most, if not all, days.
Things you cannot do
anything about also can affect cholesterol levels. These include:
Age and Gender. As
women and men get older, their cholesterol levels rise. Before
the age of menopause, women have lower total cholesterol levels
than men of the same age. After the age of menopause, women's
LDL levels tend to rise.
genes partly determine how much cholesterol your body makes.
High blood cholesterol can run in families.
In general, the higher your
LDL level and the more risk factors you have (other than LDL), the
greater your chances of developing heart disease or having a heart
attack. Some people are at high risk for a heart attack because
they already have heart disease. Other people are at high risk for
developing heart disease because they have diabetes (which is a
strong risk factor) or a combination of risk factors for heart
disease. Follow these steps to find out your risk for developing
Step 1: Check the
table below to see how many of the listed risk factors you have;
these are the risk factors that affect your LDL goal.
Major Risk Factors That
Affect Your LDL Goal
- Cigarette smoking
- High Blood Pressure
(140/90 mmHg or higher or on blood pressure medication)
- Low HDL cholesterol
(less than 40 mg/dL)*
- Family history of early
heart disease (heart disease in father or brother before age
55; heart disease in mother or sister before age 65)
- Age (men 45 years or
older; women 55 years or older)
* If your HDL cholesterol
is 60 mg/dL or higher, subtract 1 from your total count.
Even though obesity and
physical inactivity are not counted in this list, they are
conditions that need to be corrected.
Step 2: How many
major risk factors do you have? If you have 2 or more risk factors
in the table above, use
the attached risk scoring tables (which include your
cholesterol levels) to find your risk score. Risk score refers to
the chance of having a heart attack in the next 10 years, given as
a percentage. My risk score is ________%.
Step 3: Use your
medical history, number of risk factors, and risk score to find
your risk of developing heart disease or having a heart attack in
the table below.
Are in Category
disease, diabetes, or risk score more than 20%*
or more risk factors and risk score 10-20%
Next Highest Risk
or more risk factors and risk score less than 10%
or 1 risk factor
* Means that more than 20
out of 100 people in this category will have a heart attack within
My risk category is
The main goal of
cholesterol-lowering treatment is to lower your LDL level enough
to reduce your risk of developing heart disease or having a heart
attack. The higher your risk, the lower your LDL goal will be. To
find your LDL goal, see the boxes below for your risk category.
There are two main ways to lower your cholesterol:
Changes (TLC)--includes a cholesterol-lowering diet (called the
TLC diet), physical activity, and weight management. TLC is for
anyone whose LDL is above goal.
cholesterol-lowering drugs are needed, they are used together with
TLC treatment to help lower your LDL.
If you are in...
Category I, Highest
Risk, your LDL goal is less than 100 mg/dL. If your LDL is
100 or above, you will need to begin the TLC diet. If your LDL
is 130 or higher, you will need to start drug treatment at the
same time as the TLC diet. If your LDL is 100 to 129, you may
also need to start drug treatment together with the TLC diet.
Even if your LDL is below 100, you should follow the TLC diet
on your own to keep your LDL as low as possible.
Category II, Next
Highest Risk, your LDL goal is less than 130 mg/dL. If
your LDL is 130 mg/dL or above, you will need to begin
treatment with the TLC diet. If your LDL is 130 mg/dL or more
after 3 months on the TLC diet, you may need drug treatment
along with the TLC diet. If your LDL is less than 130 mg/dL,
you will need to follow the heart-healthy diet for all
Americans, which allows a little more saturated fat and
cholesterol than the TLC diet.
Moderate Risk, your LDL goal is less than 130 mg/dL. If
your LDL is 130 mg/dL or above, you will need to begin the TLC
diet. If your LDL is 160 mg/dL or more after you have tried
the TLC diet for 3 months, you may need drug treatment along
with the TLC diet. If your LDL is less than 130 mg/dL, you
will need to follow the heart-healthy diet for all Americans.
Low-to-Moderate Risk, your LDL goal is less than 160 mg/dL.
If your LDL is 160 mg/dL or above, you will need to begin the
TLC diet. If your LDL is still 160 mg/dL or more after 3
months on the TLC diet, you may need drug treatment along with
the TLC diet to lower your LDL, especially if your LDL is 190
mg/dL or more. If your LDL is less than 160 mg/dL, you will
need to follow the heart-healthy diet for all Americans.
To reduce your risk for
heart disease or keep it low, it is very important to control any
other risk factors you may have such as high blood pressure and
TLC is a set of things you
can do to help lower your LDL cholesterol. The main parts of TLC
The TLC Diet.
This is a low-saturated-fat, low-cholesterol eating plan that
calls for less than 7% of calories from saturated fat and less
than 200 mg of dietary cholesterol per day. The TLC diet
recommends only enough calories to maintain a desirable weight
and avoid weight gain. If your LDL is not lowered enough by
reducing your saturated fat and cholesterol intakes, the
amount of soluble fiber in your diet can be increased. Certain
food products that contain plant stanols or plant sterols (for
example, cholesterol-lowering margarines and salad dressings)
can also be added to the TLC diet to boost its LDL-lowering
Management. Losing weight if you are overweight can
help lower LDL and is especially important for those with a
cluster of risk factors that includes high triglyceride and/or
low HDL levels and being overweight with a large waist
measurement (more than 40 inches for men and more than 35
inches for women).
- Physical Activity.
Regular physical activity (30 minutes on most, if not all,
days) is recommended for everyone. It can help raise HDL and
lower LDL and is especially important for those with high
triglyceride and/or low HDL levels who are overweight with a
large waist measurement.
Foods low in
saturated fat include fat free or 1% dairy products,
lean meats, fish, skinless poultry, whole grain foods,
and fruits and vegetables. Look for soft margarines
(liquid or tub varieties) that are low in saturated fat
and contain little or no trans fat (another type of
dietary fat that can raise your cholesterol level).
Limit foods high in cholesterol such as liver and other
organ meats, egg yolks, and full-fat dairy products.
Good sources of
soluble fiber include oats, certain fruits (such as
oranges and pears) and vegetables (such as brussels
sprouts and carrots), and dried peas and beans.
Even if you begin drug
treatment to lower your cholesterol, you will need to continue
your treatment with lifestyle changes. This will keep the dose of
medicine as low as possible, and lower your risk in other ways as
well. There are several types of drugs available for cholesterol
lowering including statins, bile acid sequestrants, nicotinic
acid, and fibric acids. Your doctor can help decide which type of
drug is best for you. The statin drugs are very effective in
lowering LDL levels and are safe for most people. Bile acid
sequestrants also lower LDL and can be used alone or in
combination with statin drugs. Nicotinic acid lowers LDL and
triglycerides and raises HDL. Fibric acids lower LDL somewhat but
are used mainly to treat high triglyceride and low HDL levels.
Once your LDL goal has been
reached, your doctor may prescribe treatment for high
triglycerides and/or a low HDL level, if present. The treatment
includes losing weight if needed, increasing physical activity,
quitting smoking, and possibly taking a drug.