Know Your Cholesterol Level: What It Is And Why It’s Important
If you’ve already had your cholesterol measured, you know the routine: skip breakfast, get a blood test, and get your cholesterol results a few days later. You know your total cholesterol level, the number you want to keep under 200. You add these numbers together to calculate your total cholesterol.
But what are your cholesterol levels? Let’s see what these numbers tell us about your health.
What are the symptoms of high cholesterol?
High cholesterol does not usually cause any symptoms. Most of the time, they just cause emergencies. For example, a heart attack or stroke may be caused by damage from high cholesterol.
These events usually don’t happen until plaque caused by high cholesterol builds up in the arteries. Plaque narrows the arteries, allowing less blood to pass through. The formation of plaque changes the composition of the artery wall. This can lead to serious complications.
The only way to find out if you have high cholesterol is to have a blood test. If you are over the age of 20, ask your doctor for a cholesterol test. Ask your doctor to check your cholesterol after the age of 20, every 4 to 6 years.
If you have a family history of high cholesterol, your doctor may also recommend that you have your cholesterol checked more often. Or if you have any of the following risk factors
- Have high blood pressure
- Are too thin
- Smoke
What’s in the report?
Your cholesterol level is calculated by dividing your total cholesterol by your HDL count. For example, if your total cholesterol is 180 and your HDL is 82, your cholesterol ratio is 2.2. According to the American Heart Association (AHA), an ideal cholesterol level of 3.5 is a good rule of thumb, and you should strive to keep your ratio below 5.
Ratios and risks for men
According to the Framingham Heart Study, a cholesterol level of 5 indicates the average risk of heart disease in men. Men with a ratio of 9.6 have double the risk of heart disease, while men with a cholesterol ratio of 3.4 have about half the average risk of heart disease.
Ratios and risks for women
Women have a different cholesterol ratio risk category because they typically have higher levels of good cholesterol. According to the same study, a cholesterol ratio of 4.4 indicates that women have an average risk of heart disease. A ratio of 7 doubled a woman’s risk of heart disease, while a ratio of 3.3 indicated a risk of about half the average.
Same numbers, different ratios
Two people with the same total cholesterol level can have different cholesterol ratios. The ratios indicate different levels of risk for heart disease. Harvard Medical School gives the following example. If your total cholesterol is 200 and your HDL is 60, then your cholesterol ratio is 3.3. This is close to the ideal level for the AHA. However, if your HDL is 35 – below the recommended level of 40 for men and 50 for women – your cholesterol ratio would be 5.7. This ratio would put you in a higher risk category.
Know your numbers
Some people may find it easier to remember their cholesterol levels – the numbers – than to remember their HDL, LDL or total numbers. If you’re in a low-risk group, that’s fine, but if your bad cholesterol is elevated, you’ll want to pay attention to all the numbers. Knowing the risks indicated by your total cholesterol and cholesterol ratios can help you set appropriate goals to keep your numbers in a healthy range.
Taking advantage of the numbers
The AHA believes that absolute numbers of total cholesterol and HDL cholesterol are more helpful than ratios in determining cholesterol-lowering therapy. However, both are useful for assessing your overall risk. If your total cholesterol level is high, your doctor will also look at the ratio of total cholesterol to HDL cholesterol. If it is less than 5 for men and less than 4.4 for women, you are at average risk and your doctor can consider it in the overall risk assessment.
Finding the right treatment
Your cholesterol report will show you how at risk you are for heart disease. However, if you are at high risk, the report alone cannot determine which treatment is best for you. Your doctor will take your total cholesterol into account when determining the right combination of diet, exercise and medication to bring your numbers back into the ideal range.
Will my HDL be too high?
High-density lipoprotein cholesterol (HDL) is often referred to as the “good” cholesterol because it helps remove other, more harmful forms of cholesterol from the blood. It is generally believed that the higher the HDL level, the better. For most people, this is true. However, some studies have shown that for some people, high HDL levels may actually be harmful.
Recommended HDL ranges
Doctors generally recommend that you have a blood HDL level of 60 milligrams per deciliter (mg/dL) or higher. 40 to 59 mg/dL of HDL is normal, but it can be higher. If your HDL is less than 40 mg/dL, you have a higher risk of developing heart disease.
Problems associated with high HDL cholesterol levels
A study published in the journal Atherosclerosis, Thrombosis, and Vascular Biology suggests that people with high C-reactive protein levels after a heart attack can be negatively treated for high HDL C-reactive protein, a type of protein produced by the liver in situations where there is high inflammation in the body. These people’s high HDL levels may actually increase their risk of heart disease rather than protect their heart health.
While levels are still within normal limits, this type of inflammation causes the body to process HDL differently. The study looked at the blood of 767 people without diabetes who had a recent heart attack. The researchers used the data to predict outcomes for study participants, and they found that those with higher levels of HDL and C-reactive protein were a particularly high-risk group for heart disease.
Ultimately, more research is needed to determine the risk of high HDL in this particular group.
