Validation Of The Martin Method For Estimating Low
Affiliation School of Business Administration, Hallym University, Chuncheon, Korea
Affiliations School of Business Administration, Hallym University, Chuncheon, Korea, Korea Association of Health Promotion Gwangju-Jeonnam Branch, Gwangju, Korea
Affiliation Department of Anesthesiology, Kangwon National University School of Medicine, Chuncheon, Korea
Part 3 Of 3: Lowering Your Cholesterol
How To Calculate Total Cholesterol And What It Means For You
- You can calculate total cholesterol by doing a blood test called a lipid panel with your doctor.;
- Your doctor will evaluate your total cholesterol level, along with each element of your cholesterol LDL, HDL, and triglycerides to determine if you need any treatment to lower cholesterol.;
- Doctors will also take into account your medical history, including any risk factors for heart disease, to get a more complete picture of your cholesterol and heart health.;
- This article was reviewed by;Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at;Texas A&M College of Medicine.;
- This article is part of Insider’s guide to High Cholesterol.;
High cholesterol causes plaque build-up that can block arteries and lead to a greater risk of heart disease, heart attack, or stroke.;
If you want to keep your heart healthy, it’s important to understand the numbers listed on your latest blood work. Here’s what you need to know about calculating your total cholesterol.
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Question 7 My Patients Ldl Cholesterol Concentration Could Not Be Calculated Because The Triglycerides Were Too High What Options Do I Have For Getting An Ldl Cholesterol Concentration
If the LDL concentration could not be calculated because the triglyceride level was too high, direct LDL-C testing may be useful. Direct LDL measurement provides a reliable result even when triglyceride levels are up to 1,000 mg/dL. It can be ordered as a stand-alone test, as a reflex if the patients triglyceridelevel is likely to exceed 400 mg/dL, or as part of one of several panels. The table below lists tests and panels that include direct LDL-C measurement or reflex to direct LDL-C measurement when the triglyceride level is above 400 mg/dL:
Cholesterol And Its Consequences
Without cholesterol, the life of humans and animals would not be possible. It is an essential structural component of cell membranes, and is needed in the process of production of steroid hormones, bile acids, and vitamin D. Moreover, you should notice that in certain clinical situations there are too low levels of cholesterol, but it is not very often. This is so-called hypocholesterolemia. It is usually caused by hyperthyroidism , adrenal insufficiency, liver diseases, depression, cerebral hemorrhage, or cancer. In sporadic cases it is caused by SLOS – a genetic abnormality in the process of synthesis of cholesterol.
On the other hand, high levels of cholesterol, so-called hypercholesterolemia lead to substantial health problems. The most important consequence of high cholesterol is atherosclerosis. It is a disease in which the inside of an artery narrows due to the accumulation of plaque. At first patients usually don’t have any symptoms, but eventually it causes:
- coronary artery disease
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Question 1 Why Is Ldl
The level of low-density lipoprotein-cholesterol , among other factors, correlates with the likelihood of developing atherosclerotic cardiovascular disease . Thus, LDL-C measurement is useful for assessing ASCVD risk, stratifying individuals into treatment benefit groups, and monitoring risk-reduction therapy.1
How To Calculate Total Cholesterol
This article was medically reviewed by Victor Catania, MD. Dr. Catania is a board certified Family Medicine Physician in Pennsylvania. He received his MD from the Medical University of the Americas in 2012 and completed his residency in Family Medicine at the Robert Packer Hospital. He is a member of the American Board of Family Medicine.There are 9 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article received 11 testimonials and 83% of readers who voted found it helpful, earning it our reader-approved status. This article has been viewed 187,970 times.
Note: In the information below, a lab test interpretation of the values may vary between labs and between doctors. Always view your lab results and speak to your doctor before coming to any conclusions about your lab test values.
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Understanding Lipid Panel Results
“Your total cholesterol along with the ratio of bad to good cholesterol are very important when considering your risk for future heart issues,” says Addison Haynes, DO, a physician at Indiana University Health.;
Knowing your total cholesterol is helpful, but it’s better to take into account your LDL and HDL cholesterol along with your triglycerides .
In the past, doctors would examine each value and make treatment recommendations based on how they fell within the desirable numbers. While that method is still used, Haynes says doctors are increasingly working with their patients to take into account their entire health profile, including specific risk factors like family history or lifestyle, before creating a plan for treatment.
“As we learn more and more about the human body and gather more data, we have changed how we treat cholesterol,” he says. “We now look at a person’s risk factors for having a cardiac event when we consider treatment options rather than the number by itself.”
How Often You Should Measure Total Cholesterol
According to Haynes, if risk factors are present such as a strong family history of heart disease or diabetes you should visit the doctor to calculate your total cholesterol every year. This allows you and your doctor to remain aware of changes in your health and respond in a timely fashion to lower your risk for heart disease and stroke.
Haynes says that young adults who are under the age of 40 and don’t have any major risk factors only need to meet with their doctor to have their total cholesterol checked every 3 to 5 years. However, if you’re worried about high cholesterol, you should consider checking in with your doctor more frequently.
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Question 6 Is Fasting Required When Using The Martin
The need for fasting varies with the indication for testing, and the method used to calculate LDL-C should not affect the decision to require fasting samples. However, as noted above, the ability of the Martin-Hopkins calculation to adjust for high triglyceride levels may also make LDL-C estimation more reliable in nonfasting patients.8
What Happens If High Cholesterol Goes Untreated
High blood levels of LDL cholesterol and triglycerides have been linked to the development of CVDs, along with other factors such as hypertension and diabetes mellitus. The risk of damage to the vascular walls and the formation of deposits and blockages increases when there is more bad and less good cholesterol in our blood. The good news is that the reduction in total cholesterol by 1% leads to a 2% reduction in the risk of developing cardiovascular disease.
Increased cholesterol levels may be caused by a familial predisposition as well, as is the case in about 3% of people. Usually, blood cholesterol is high from an early age and is unaffected by the diet. In these cases, specialists recommend taking lipid-lowering agents such as statins from a younger age. These drugs are prescribed and taken under medical supervision.
However, it is a myth that lipid-lowering medication can be stopped as soon as your results are within the cholesterol and triglycerides normal range. The levels may be lowered, but if you stop taking the drug, the cholesterol, and especially LDL, will rise again. You should consult your doctor about any change in your treatment.
In about20% of the population, high LDL cholesterol levels are associated with another underlying condition such as:
- increased adrenal function
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New Information On Accuracy Of Ldl
Low-density lipoprotein-cholesterol remains of utmost clinical importance; it is positioned in clinical trials as a treatment target and is emphasized in worldwide guidelines as the primary cholesterol target. The gold standard of LDL-C measurement has been preparative ultracentrifugation, but given its time requirements and expenses, other methods have been developed as alternatives to estimate LDL-C.
The Friedewald equation was developed in 1972 and estimates LDL-C as: total cholesterol minus high-density lipoprotein-cholesterol minus triglycerides /5, with the latter term serving as an estimate for very low-density lipoprotein-cholesterol .1 Originally developed for research purposes from a sample of just 448 individuals, the Friedewald equation has been widely adopted in clinical practice for several decades.
However, the equation is prone to inaccuracy at low LDL-C and/or high TG levels, where errors in estimating VLDL-C are magnified given its use of a fixed factor of 5 to describe the relationship between TG and VLDL-C. This results in marked underestimation of LDL-C.
In the era when the Friedewald equation was introduced, inaccuracies were tolerated because the VLDL-C estimate was a relatively small proportion of the equation. Lower LDL-C levels were not achievable or strongly recommended as statins and other modern pharmacotherapies were not available. In fact, only 35 individuals in Friedewald’s derivation sample had an LDL-C <100 mg/dL.1
Bad Cholesterol Levelsduring The Pandemic
Recent research has proven that people with high LDL cholesterol are at an increased risk of getting COVID-19. In fact, scientists think that LDL leads to vasculopathy in COVID-19 patients. The virus puts the body in a pro-inflammatory state, harming the lung tissues and the heart while increasing the chances of coagulopathy or blood clots, too. So, people with high cholesterol and COVID-19 are at even higher risk of having a cardiovascular event.
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Why You Need To Get Your Cholesterol Levels Tested
Cholesterol and lipid tests are blood tests that measure the amount of different forms of cholesterol in the blood. All these forms are called lipids. The test measures total blood cholesterol, the levels of HDL , the levels of LDL and triglycerides.
The relation between all these levels can determine the risk for developing a heart disease. Since raised levels are mostly asymptomatic, medical professionals are advising everyone over the age of 20 to have them tested regularly.
Determining if you have high cholesterol can be the first step towards lowering it and therefore reducing risks related such big values.
When Should I Get Ldl Cholesterol Testing
LDL cholesterol testing may be used to assess your risk of cardiovascular disease or monitor changes in cholesterol over time.
Doctors will take factors such as age, family history, and other medical conditions when determining how often you should check your levels of LDL cholesterol. Examples of common screening recommendations are outlined below:
|With or without risk factors||Annually|
Having your cholesterol levels checked at regular intervals gives doctors a chance to notice any changes that could become harmful to your health. High or increasing cholesterol levels are a risk factor for heart disease, diabetes, or stroke, among other conditions.
Doctors may want to test your cholesterol levels more regularly if you or your family have a history of heart disease, smoking, high blood pressure, type 2 diabetes, obesity, a sedentary lifestyle, or a diet high in saturated fat.
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A More Accurate Measurement Tool
The traditional Friedewald equation estimates LDL cholesterol this way: total cholesterol minus HDL cholesterol minus triglycerides divided by five. For simplicitys sake, the formula applies a one-size-fits-all factor of five to everyone. But Johns Hopkins researchers found that this often makes LDL cholesterol appear lower than it really is for some high-risk patients. The researchers sought a more accurate formula that would take into account specific details about a persons cholesterol and triglyceride levels.
Using a database of blood lipid samples from more than 1.3 million Americansalmost 3,000 times larger than the one used to develop the Friedewald equation Johns Hopkins researchers developed a more accurate system for calculating LDL cholesterol. It can be used to make more precise decisions about treatment to prevent heart attack and stroke.
This newer LDL cholesterol formula is being adopted by U.S. laboratories as well as others around the world. The best implementation is direct coding the LDL cholesterol estimation in the lab IT system, which automates the process and saves clinicians time. The formula is also available as a mobile device app called the LDL Cholesterol Calculator. It is available on the iTunes App Store and on Google Play, for those whose lab hasnt adopted it.
Researchers hope the new formula will one day be adopted by all labs that process lipid panels, as it can improve patient care.
Can I Take The Test At Home
At-home cholesterol testing is available to measure calculated levels of LDL cholesterol. At-home testing for cholesterol uses a blood sample taken by a device that pricks your finger to obtain a small drop of blood that can be tested.
There are two types of at-home LDL tests that use a fingerstick blood sample:
- Self-tests:;In this kind of test, the analysis of your blood happens at home. This can be done by applying a drop of blood on paper that is then placed into a small device that determines the cholesterol levels. Another type of self-test uses chemically treated paper that indicates the levels of cholesterol in your blood.
- Self-collection:;For this kind of test, your blood sample is taken at home but is then sent to a laboratory for analysis.
For help deciding whether an at-home cholesterol test kit is right for you, it may be helpful to talk to your primary care doctor or cardiologist. It is common to have a follow-up cholesterol test performed by a doctor if an at-home cholesterol test kit finds abnormal results.
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How To Calculate Cholesterol Ratios
There are three indicators that describe your heart disease risk with high accuracy. They are all built as ratios of the aforementioned blood results, and are therefore called cholesterol ratios.
Are you wondering what a good cholesterol ratio is? You can use this total cholesterol calculator to find the following values:
- ideal: below 2.0
- good: below 5.0
- too high: above 5.0
If you measure the values in mg/dL, the normal range for the triglyceride HDL ratio is:
- ideal: 2.0 or less
- high: 4.0 – 6.0
- too high: 6.0 or above
For a calculation of this ratio in mmol/L , the normal range of the ratio value is different:
- ideal: 0.87 or less
- high: 1.74 – 2.62
- too high: 2.62 or above
Check out our cholesterol units calculator to fully understand the conversion between mmol/L and mg/dL units.
- ideal: under 3.5
- bad: over 5.0
Cholesterol Levels Measurement Units
Cholesterol is typically measured in milligrams per deciliter .Millimoles per liter is the standard medical unit for measuring concentrations of substances in blood. It’s used in Canada and some European countries.Various publications use either one or the other unit and it can be confusing to understand the guidelines. Our cholesterol calculator is here to help you.
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What Does The Test Measure
An LDL cholesterol test checks the amount of LDL cholesterol in the blood. Results are typically measured in milligrams per deciliter .
Cholesterol is a fatty substance your body naturally creates to help in digesting food, creating hormones, and making vitamin D. Cholesterol is made up of different types of lipoproteins, which are a combination of fats, also known as lipids, and proteins. Lipids connect to proteins to be able to move through your blood. Cholesterol testing often measures different substances in the blood:
- High-density cholesterol: HDL carries cholesterol from other parts of your body to your liver for processing and removal and is considered the good cholesterol.
- Low-density cholesterol: LDL is known as the bad cholesterol because too much of it in your blood can lead to a buildup of plaque in your arteries, putting you at risk of heart disease, diabetes, or stroke.
- Triglycerides:;Triglycerides are fats created by the foods we eat. These fats are stored until your body needs energy. Triglycerides are processed by your body when it needs energy. Having high levels of triglycerides can lead to coronary heart disease and other cardiovascular issues.
- Very low-density cholesterol: VLDL is similar to LDL cholesterol but carries triglycerides through the blood. VLDL can contribute to plaque buildup and is considered a bad cholesterol.