|The National Cholesterol Education Program (NCEP) guidelines recommend that people age 20 and older get a fasting blood testómeaning blood is drawn after 10 to 12 hours without food. The test measures your cholesterol in milligrams per deciliter of blood (mg/dL).
Called a lipid profile and used in the evaluation of coronary risk factors, this test will show your total cholesterol and levels of what Paul. D . Thompson, MD, director of cardiology at Hartford Hospital in Hartford, Connecticut, dubs the good, high-density lipoprotein (HDL); the bad, very high-density lipoprotein (VLDL/triglycerides); and the ugly, low-density lipoprotein (LDL). The basis of the total cholesterol count is defined as the sum of HDL, LDL and VLDL (very low density lipoprotein).
HDL: The "Good" Cholesterol
Cholesterol tends to get a bad rap, but not all cholesterol is harmful. "HDL has a protective effect over future heart disease," says Keteyian. It works in the body by carrying cholesterol away from the arteries to the liver, where it is passed from the body. For HDL cholesterol, the higher numbers the better, and low HDL, less than 40 mg/dL(more specifically, less than 37 mg/dL in men and less than 47 mg/dL in women) is cause for concern because it increases your risk of heart disease.
LDL: The "Bad" Cholesterol
LDL is the artery-clogging substance that doctors keep an eye on most. "If you have high cholesterol, often, but not always, it's due to high LDL," says Thompson.
With a high LDL level, fats stick to the lining of blood vessels, contributing to atherosclerosis, the build-up of plaque on the inner lining of medium- and large-sized arteries. This constricts blood flow, making the arteries vulnerable to rupturing. Ruptures cause blood clots that can either travel to the heart and cause a heart attack, or to the brain and cause a stroke.
Total Cholesterol Ranges
- Desirable total cholesterol: less than 200 mg/dL
- Borderline-high cholesterol: 200 to 239 mg/dL
- High cholesterol: 240 mg/dL and up
- Optimal level of LDL: less than 100 mg/dL
- Nearly 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 above
Note: People with a known heart problem, diabetes, or both, should aim for numbers even lower than these.