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Is Total Cholesterol Hdl Plus Ldl

Diet And Lifestyle Changes

Total Cholesterol Score

A doctor will look at your overall risk of cardiovascular disease and make recommendations to reduce high blood cholesterol as well as managing other risk factors such as high blood pressure, smoking and being overweight.

Reducing high blood cholesterol levels typically involves decreasing the total cholesterol level by decreasing LDL-cholesterol and triglycerides, while maintaining or increasing HDL-cholesterol levels.

  • LDL-cholesterol levels are best decreased by eating less saturated fat
  • Triglyceride levels are best reduced by eating less sugar-containing foods, limiting alcohol intake, and reducing the intake of total fat
  • HDL-cholesterol levels are best increased by exercise, substituting saturated fats with polyunsaturated or monounsaturated fat , and maintaining a healthy weight.

Heart-healthy dietary changes are summarised in our Heart disease diet page.

Other lifestyle changes should include:

  • Exercising regularly
  • Maintaining a healthy body weight
  • Limiting alcohol intake

Heart-healthy exercise suggestions are summarised in our Heart disease exercise page.

Understanding What Your Cholesterol Levels Mean

Medical professionals typically perform cholesterol levels testing among the battery of medical check-ups. They do so because high cholesterol or hypercholesterolemia is a popular medical condition that may considerably have an impact on your heart and overall health. To evaluate your blood cholesterol levels, your physician is going to perform a blood test known as a lipid panel, as well as a lipid profile. It is recommended to not eat or drink anything, apart from water, for approximately 9 hours before the exam to ensure correct evaluation results., while recent studies suggest that it is not necessary. With this guide, you will understand what your results mean. You will know about the total cholesterol, the HDL, the LDL, the triglycerides and even a less popular lipoprotein such as the VLDL. Keep reading!

How Does Cholesterol Cause A Heart Attack

Bad forms of cholesterol seep into the inner walls of the arteries, creating plaque. Like sores on your skin, plaques are raw, sensitive to infection, which means they make the inside skin of the arteries a breeding ground for inflammation.

High blood levels of bad cholesterol can lead to heart attacks.

The higher our blood levels of bad cholesterol, the more plaques tend to form, and the more inflamed the arterial skin becomes.

Plaque build-up is also known as atherosclerosis.

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What Happens During A Cholesterol Test

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Cholesterol tests are usually done in the morning, as you may be asked to refrain from eating for several hours prior to the test.

You may also be able to use an at-home kit to test for cholesterol. While instructions may vary between brands, your kit will include some kind of device to prick your finger. Youll use this device to collect a drop of blood for testing. Be sure to follow the kit instructions carefully.

Also, be sure to tell your health care provider if your at-home test results shown your cholesterol level is higher than 200 mg/dl.

How Is An Hdl Cholesterol Test Different From A Low

Lipid profile analysis and serum ALT. (a) Total ...

An HDL cholesterol test and LDL cholesterol test measure different types of cholesterol. The two types of cholesterol are transported in the blood in distinct kinds of particles.

In common descriptions, HDL cholesterol is known as good cholesterol while LDL cholesterol is bad cholesterol. The amount of HDL cholesterol compared to LDL cholesterol can be an important consideration in cardiovascular health.

Measuring HDL cholesterol is more straightforward than measuring LDL cholesterol. For this reason, levels of LDL cholesterol are most often calculated using a formula based on levels of total cholesterol, HDL cholesterol, and triglycerides. In some situations, though, a doctor may prescribe a direct LDL test.

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Do I Need To Take Medications For High Cholesterol

Simply looking at a chart to determine where your cholesterol levels falls cant fully answer if you need treatment for high cholesterol. Many other factors that must be considered.

Your doctor can explain your levels to you and make recommendations based not only on your cholesterol test results, but also other risk factors you may have such as:

  • a history of coronary heart disease
  • your lifestyle, such as diet and exercise habits
  • if you smoke.

Your doctor may also calculate your 10-year risk for heart disease to determine your need for medication. Ask your physician if this number has been calculated and how to interpret the results.

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The Composition Of Ldl Cholesterol: Why It Matters

While it was traditionally thought that high LDL cholesterol as a whole was bad and a predictor of heart disease complications, new research, including a 2019 study from Ohio University, suggests that the real predictor of complications may be a particular subclass of LDL.

LDL is comprised of three subclasses of low-density lipoproteins, A, B, and I. According to researchers, one subclass subclass B was found to be the most damaging and a much better predictor of potential heart attacks than the total measurement of LDL.

While this type of research is new and evolving, if you are concerned about your LDL numbers and the possibility of complications, talk with your doctor.

If youve been diagnosed with high LDL, the good news is that there are ways to lower it to a healthier range.

If your doctor is concerned about your LDL levels, they may prescribe medication, such as:

Each drug has its own side effects, so its important to talk with your doctor about why theyre prescribing a specific medication and what the possible side effects might be.

Your doctor will also likely recommend specific lifestyle changes regardless of whether youre prescribed medication.

If your lipid test shows high or borderline-high LDL levels, your doctor will most likely recommend some lifestyle changes that can make a positive impact on your cholesterol as a whole based on your specific situation.

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Predicting The Magnitude Of The Preventive Effect

The total/HDL cholesterol and LDL/HDL cholesterol ratios are also good predictors of the degree of clinical benefit to be derived from lipid-lowering intervention. In the LRC-CPPT with cholestyramine, the drops in the total/HDL cholesterol ratio in the active treatment group were associated with clinical benefit. In the Helsinki study, multivariate analysis of the relationship between the lipid changes induced by gemfibrozil and the incidence of cardiovascular events in the treated group showed better predictive value for changes in HDL cholesterol and the total/HDL cholesterol ratio. In the placebo group of the AFCAPS/TexCAPS study, baseline LDL cholesterol had no predictive value for the incidence of coronary events, whereas predictive value was found in HDL cholesterol and the total/HDL cholesterol and LDL/HDL cholesterol ratios, both with greater significance than HDL cholesterol by adjusted logistic regression in the active treatment group, only changes in apoB and the apoB/apoA-I ratio, which is largely equivalent to the LDL/HDL cholesterol ratio, predicted risk reduction. The total/HDL cholesterol ratio also had more predictive value than other lipid parameters in the control group of the 4S study treatment-induced changes in this ratio were the best risk predictors in the group receiving simvastatin, with an estimated 17.6% risk difference for every one-unit reduction in the ratio.

What Is High Cholesterol

Why total cholesterol is more important than HDL or LDL

There are two major forms of cholesterol: Low-density lipoprotein or LDL, also known as “bad” cholesterol, and high-density lipoprotein or HDL, also called “good” cholesterol. LDL is the main source of artery-clogging plaque. HDL, on the other hand, clears cholesterol from your blood.

Besides LDL and HDL, there√Ęs another kind of fat in your blood called triglycerides. Research shows that high levels of triglycerides, just like high levels of LDL, are linked to heart disease.

Your body needs cholesterol to build new cells, insulate nerves, and make hormones. Having too much, though, is a major risk for heart disease.

Ordinarily, your liver makes all the cholesterol your body needs. But you also get cholesterol from food. You’ll find these in many processed foods like doughnuts, frozen pizza, cookies, and crackers. You can also get it from milk, eggs, meat, and other animal products. Over time, without your even being aware, this extra cholesterol collects inside your body and begins to do damage.

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Key Lifestyle Actions To Lower Triglyceride Levels:

  • Lose excess weight.
  • Eat less sugar and other highly refined and processed carbohydrates, like white breads. Focus on good carbs.
  • Eat more fish and omega-3 fats.
  • Drink very little alcohol.
  • Exercise regularly: 1) Aerobic exercise daily, a minimum of 30 minutes and optimally 60 to 90 minutes, alternating moderate-intensity days with vigorous-intensity days 2) Full-body resistance routine two to three times weekly and 3) Stretching exercises daily to greatly enhance your overall flexibility and ability to exercise more freely.

What Do My Cholesterol Results Mean

What do my cholesterol results mean? What about LDL? HDL? Triglycerides? How do I improve my numbers?

Get answers from the physicians and other health professionals at the Pritikin Longevity Center in Miami. Pritikin has been helping people launch heart-healthy lifestyles since 1975.

Did you know that our bodies manufacture all the cholesterol we need? We get more from the cholesterol we eat.

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For People With Heart Disease

For people who have advanced atherosclerosis , the goal for non-HDL is lower.

Evidence-based research, for example, a trial that followed 18,144 heart patients as well as another study that treated 202 heart patients, indicate that a non-HDL less than 80 is optimal for those with clear evidence of coronary artery disease.

For those at highest risk of a cardiovascular event, a non-HDL target of 70 might provide even more protection.

What Do The Results Mean

Total, LDL

Cholesterol is usually measured in milligrams of cholesterol per deciliter of blood. The information below shows how the different types of cholesterol measurements are categorized.

Total Cholesterol Level
Less than 40 mg/dLA major risk factor for heart disease

A healthy cholesterol range for you may depend on your age, family history, lifestyle, and other risk factors. In general, low LDL levels and high HDL cholesterol levels are good for heart health. High levels of triglycerides may also put you at risk for heart disease.

The LDL on your results may say “calculated” which means it includes a calculation of total cholesterol, HDL, and triglycerides. Your LDL level may also be measured “directly,” without using other measurements. Regardless, you want your LDL number to be low.

Learn more about laboratory tests, reference ranges, and understanding results.

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What To Know About Triglycerides

In addition to cholesterol, you might hear about your triglycerides, another kind of fat found in the bloodstream. Women should pay particular attention to this. A high level of triglycerides seems to predict an even greater risk for heart disease in women compared with men, says Michos.

When you take in more calories than you need, your body converts the extra calories into triglycerides, which are then stored in fat cells. Triglycerides are used by the body for energy, but people with excess triglycerides have higher risk of medical problems, including cardiovascular disease. Drinking a lot of alcohol and eating foods containing simple carbohydrates , saturated fats and trans fats contributes to high triglycerides. High levels may also be caused by health conditions such as diabetes, an underactive thyroid, obesity, polycystic ovary syndrome or kidney disease.

Triglycerides also circulate in the bloodstream on particles that may contribute to plaque formation. Many people with high triglycerides have other risk factors for atherosclerosis, including high LDL levels or low HDL levels, or abnormal blood sugar levels. Genetic studies have also shown some association between triglycerides and cardiovascular disease.

High Cholesterol: Prevention, Treatment and Research

How Is An Hdl Cholesterol Test Different From A Lipid Panel

A lipid panel always includes a measurement of HDL cholesterol, but HDL cholesterol levels can be tested without doing a full lipid panel.

A standard lipid panel measures total cholesterol, HDL cholesterol, and triglycerides. It then uses those measurements to calculate the amount of LDL cholesterol.

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When Should I Get An Hdl Cholesterol Test

Whether an HDL cholesterol test is appropriate depends on your specific circumstances.

As a screening test, there are no universally agreed-upon recommendations regarding how often to measure cholesterol levels. In general, screening is started earlier for people with risk factors such as high blood pressure, cigarette smoking, diabetes, or a family history of heart disease at an earlier age. Ongoing cholesterol testing may occur more often in people with one or more of these risk factors.

People without an elevated risk for cardiovascular problems usually start screening at a later age and often have longer intervals between cholesterol tests.

Every individual should talk with their doctor about the most appropriate screening plan in their specific situation. An overview of common recommendations for cholesterol screening are listed in the table below:

Demographic Group
With or without risk factorsAnnually

Screening is frequently done with a lipid panel, especially for an initial test. However, some screening may be done with only a total cholesterol and HDL-C measurement.

Although principally used to detect cardiovascular issues, abnormalities in HDL cholesterol can occur with other health problems affecting the thyroid, pancreas, or liver. As a result, cholesterol testing may be involved in the diagnostic process for a range of medical conditions.

How To Lower Ldl Cholesterol

Cholesterol and Targets for Total Cholesterol, LDL and HDL

Lifestyle and diet changes are the main ways to prevent or lower high LDL. A trial of eating a low-fat diet, regular aerobic activity, maintaining a healthy weight, and smaller waist circumference is an appropriate first step. It is best to set a timeline to achieve your goals with your doctor. In some cases, if those lifestyle changes are not enough, your physician may suggest a cholesterol lowering medication, such as a statin. If you are considering over-the-counter herbal or ayurvedic medications for cholesterol, please discuss those with your physician first as well.

Rarely, very high LDL is genetic and passed down in families. This is called familial hypercholesterolemia and is caused by a genetic mutation that decreases the livers ability to clear excess cholesterol. This condition can lead to very high LDL levels, and heart attack or stroke at a young age in multiple generations. Those individuals may require special medical treatment for prevention and treatment of atherosclerotic cardiovascular disease.

Remember, knowledge is the first step. If you dont know your cholesterol levels, get tested. That will give you and your physician a starting point for lifestyle changes and medications if needed. In the meantime, adopt a heart-healthy lifestyle, and do it with friends and family no matter their ages. Theres no time like the present to prevent heart disease.

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Further Information And Support

For assessment and treatment of high cholesterol levels see a doctor. For ideas about how to lower high cholesterol levels a doctor or dietitian can assist.

Our Heart disease diet and Heart disease exercise pages provide practical ideas and ways to get started with healthier lifestyles in general, including cholesterol reduction.

Are Test Results Accurate

HDL cholesterol testing is extremely common and frequently used to evaluate cardiovascular risk. Like any test, though, HDL cholesterol tests are not perfectly accurate. Certain factors that can influence accuracy of any single test include:

  • Individual variability: There can be some differences in HDL cholesterol levels based on individual factors like stress or posture during the test. Minor variation can also occur between laboratories.
  • Acute illness: Levels of cholesterol in the blood are affected by inflammation, so infections or other illnesses that produce inflammation may interfere with the accuracy of HDL cholesterol tests.
  • Certain blood disorders: Some conditions that affect blood cells cause an increase in a type of protein, known as an M protein, in the blood. In people with these conditions, HDL cholesterol tests may show a lower level of HDL cholesterol than is actually present in their blood.

Point-of-care and at-home tests that use a fingerstick blood sample are nearly as accurate as laboratory testing, but there may be more variability in accuracy based on the brand and the quality of its test.

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How Can I Lower My Cholesterol

There are two main ways to lower your cholesterol:

  • Heart-healthy lifestyle changes, which include:
    • Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated and trans fats that you eat. Examples include the Therapeutic Lifestyle Changes diet and the DASH Eating Plan.
    • Weight Management. If you are overweight, losing weight can help lower your LDL cholesterol.
    • Physical Activity. Everyone should get regular physical activity .
    • Managing stress. Research has shown that chronic stress can sometimes raise your LDL cholesterol and lower your HDL cholesterol.
    • Quitting smoking.Quitting smoking can raise your HDL cholesterol. Since HDL helps to remove LDL cholesterol from your arteries, having more HDL can help to lower your LDL cholesterol.
  • Drug Treatment. If lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol medicines available, including statins. The medicines work in different ways and can have different side effects. Talk to your health care provider about which one is right for you. While you are taking medicines to lower your cholesterol, you should continue with the lifestyle changes.

NIH: National Heart, Lung, and Blood Institute

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