Sorting Out Your Cholesterol

That ‘total’ number is not enough to predict your heart disease risk!

Targets* to aim for

• Total cholesterol below 200
• LDL below 100 for men or women
• HDL above 40 for men, 50 for women
• Ratio below 4.0 for men, 3.0 for women

*If you don’t have heart disease or diabetes

So you learned that your total cholesterol count is in the normal range, and now you’re in the clear, right? Maybe—but that one number doesn’t tell you enough to know for sure. “You need all your cholesterol numbers to determine your future risk for heart disease,” says cardiologist Andrew Sumner, M.D., of Lehigh Valley Hospital and Health Network.

Ask your doctor for a breakdown that includes total cholesterol, LDL (“bad”) cholesterol, HDL (“good”) cholesterol, and the ratio of HDL to total.

Why is this important? Your total cholesterol (the combination of LDL, HDL and other blood cholesterol particles) may be in the normal range, but within that total you could have a high LDL and a very low HDL, an unhealthy combination that raises your risk for heart disease. On the other hand, you could have a relatively low LDL and a very high HDL, a super cholesterol combo that lowers your heart disease risk. Very high HDL is protective even if it pushes your total cholesterol over 200, Sumner says.

You can see how good HDL keeps bad LDL in check by computing your cholesterol ratio, another valuable number to know. Divide your total cholesterol by your HDL. The goal for healthy people is below 4.0 for men, 3.0 for women.

What can you do if your cholesterol picture turns out not so rosy? First, talk with your doctor about your personal heart disease risk factors (including family history, age, smoking and diabetes, among others). This helps determine what your cholesterol goals should be; the higher the risk, the more aggressive the goals.

To achieve healthier levels, trim down if you’re overweight, cut saturated fats from your diet, and exercise regularly (it’s proven to boost HDL). “Genes play a role in how your body makes and handles cholesterol, so when diet and exercise don’t keep it in check, cholesterol-lowering medications are necessary,” says Sumner’s colleague, internist Yehia Mishriki, M.D.

What about triglycerides? They’re another harmful fat in the blood. “Research suggests that people with high triglycerides and low HDLs have a higher risk for developing coronary artery disease,” Sumner says. Triglycerides above 150 raise the risk for metabolic syndrome, a precursor to diabetes and heart disease.

Want to Know More about heart disease risk factors, metabolic syndrome or how fats affect cholesterol? Call 610-402-CARE. Get Your Cholesterol Under Control

Published from Healthy You Magazine, January-February 2008

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