Health Checkup: The Good and the Bad about Cholesterol

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February is American Heart Month, and I will be discussing over the next two issues how certain cardiac risk factors can be controlled and thus reduce your risk of heart disease and stroke. This issue will talk about cholesterol.

Cholesterol is a fat-like substance found in your blood and in all your body’s cells. The American Heart Association says you need a certain amount of cholesterol for good health. Too much cholesterol in your blood, however, can lead to clogged arteries.

Total blood cholesterol is the most common measurement of blood cholesterol and is expressed in milligrams per deciliter (mg/dl).

Less than 200 mg/dl: Normal. This level places you at lower risk for heart disease.

200-239 mg/dl: Borderline.

240 mg/dl and above: High. A person with this level is twice as likely to develop heart disease as someone whose cholesterol is below 200.

One’s total cholesterol level, though, does not tell the entire story. There are two types of lipoproteins that transport cholesterol in your bloodstream: the high-density lipoprotein (HDL) or “good” cholesterol and the low-density (LDL) lipoprotein or “bad” cholesterol.

High-density lipoprotein (HDL) is believed to be beneficial to your heart by removing cholesterol from the blood vessels. Remember: a low level HDL is less protective for your heart:

Less than 40 mg/dl for men &
Less than 50 mg/dl for women
: May increase your risk of heart disease.

60 mg/dl and above for men & women: May lower your risk of heart disease.

Low-density (LDL) lipoprotein is the so-called “bad” cholesterol. It allows cholesterol to build up and block arteries resulting in a heart attack or stroke. An acceptable LDL level depends on whether you have diabetes mellitus or coronary heart disease.

Less than 100 mg/dl: Acceptable goal for individuals with diabetes or heart disease.

Less than 130 mg/dl: Acceptable goal for average-risk individuals.

Triglycerides are another form of fat in the blood that can increase your risk of heart disease.

Triglyceride levels are considered to be borderline high at 150-199 mg/dl or high at 200 mg/dl or more.

The American Heart Association recommends that everyone age 20 and older have a fasting “lipoprotein profile” performed. This test is done after a 9- to 12-hour fast (no food, liquids or pills). The “lipoprotein profile” provides information about:

• Total cholesterol
• Low-density lipoprotein (LDL) or “bad” cholesterol
• High-density lipoprotein (HDL) or “good” cholesterol
• Triglycerides

Your doctor will determine how often to perform the lipoprotein profile based on your age and other health risk factors. Your doctor may recommend treatment if the results are in the abnormal range on several lipoprotein profiles.

Treatment to improve your lipoprotein profile may start with a proper diet and exercise. However, if the levels do not improve using these methods, then prescription medication will be required. As with all treatments, it is important that you talk to your doctor.