How To Get Tested
There are several different ways that HDL cholesterol levels can be tested.
Your doctor may prescribe a laboratory test, which requires taking a blood sample from a vein in your arm in a medical office or hospital.
Some clinics, doctors offices, pharmacies, and events like health fairs also offer on-site cholesterol testing. Known as point-of-care testing, this test analyzes a drop of blood that comes from pricking your fingertip with a very small needle.
What Does Ldl Cholesterol Do
LDL is considered the bad cholesterol. It carries cholesterol to your arteries, where it may collect in the vessel walls and contribute to plaque formation, known as atherosclerosis. This can lead to decreased blood flow to the heart muscle , leg muscles , or abrupt closure of an artery in the heart or brain, leading to a heart attack or stroke. Over a third of the US population has high LDL cholesterol. Diagnosis is made via blood testing, so if you dont check, you wont know.
For LDL, the lower the number the better. A good goal to keep in mind is less than 130 mg/dL if you dont have atherosclerotic disease or diabetes. It should be no more than 100 mg/dL, or even 70mg/dL, if you have any of those conditions or high total cholesterol. Its very important to set your own target cholesterol levels with your doctor. Obesity, a large waist circumference, a sedentary lifestyle, or a diet rich in red meat, full-fat dairy, saturated fat, trans fats, and processed foods can lead to high LDL cholesterol.
Total Cholesterol To Hdl Ratios
The total cholesterol to HDL cholesterol ratio can help a person know if they are consuming enough good cholesterol and to limit sources of bad cholesterol. It can be measured by dividing the total cholesterol by the HDL level.
Ideally, the ratio should be below 4. The lower this number is, the healthier a persons cholesterol levels are.
Total cholesterol does fluctuate, so more than one blood test might be required for an accurate assessment. Levels can change following a meal, so sometimes a blood test will be taken first thing in the morning before a person has breakfast.
suggest that the total cholesterol to HDL ratio is a better marker of the risk of heart disease than LDL cholesterol levels alone.
Non-HDL cholesterol
Another method of assessing cholesterol levels is calculating a non-HDL cholesterol level. This is measured by subtracting HDL cholesterol from the total cholesterol.
This method is considered to be more accurate by some doctors because it includes very low-density lipoprotein levels in the calculation.
Similarly to LDL cholesterol, VLDL cholesterol can also build up inside the walls of blood vessels, which is undesirable.
Ideally, a non-HDL cholesterol level should be less than 130 mg/dL. A higher value than that increases the risk for heart disease.
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How Is An Hdl Cholesterol Test Different From A Low
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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How Often Should I Get My Cholesterol Levels Checked
The frequency of getting your cholesterol levels tested depends on your age, presence of risk factors, and family history like a history of heart diseases, stroke, diabetes, or high cholesterol.
The following provides general recommendations for various age groups.
People who are 19 years of age or younger should:
- Get the first test done between ages 9 to 11 years
- Repeat the test every 5 years
- For children, who have a family history of high blood cholesterol, heart attack, or stroke, the testing may start at 2 years of age
People who are age 20 years or older:
- Those between the age of 20 to 44 years should get tested every 5 years
- Women in the age group 45 to 54 years should get tested every 5 years
- Men in the age group 45 to 65 years should get their cholesterol levels checked every 1-2 years
- Women in the age group 55 to 65 years should get tested every 1-2 years
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Does Alcohol Affect Cholesterol
Consuming alcohol can raise cholesterol levels because alcohol is processed through the same organ that is responsible for making cholesterol. For example, studies show that excessive drinking may increase LDL levels, which is the bad type of cholesterol. In addition, alcohol is known to raise triglyceride levels.
Why Is It Good
Due to the fact that cholesterol cannot dissolve in the blood, it counts on lipoproteins to transport it to and from cells. Good cholesterol is responsible for sweeping the artery-clogging bad cholesterol from the blood stream and taking it to the liver, adrenals, ovaries, and testes. In essence, HDL cholesterol is the good cholesterol since it gets rid of bad cholesterol from the body. Because of this, HDL cholesterol is responsible for lowering the hardening of the arteries, which decreases your risk of heart attack or heart disease.
Research has likewise found that having a low HDL level increases your chances of amnesia and dementia.
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What Makes Hdl Cholesterol So Good
HDL is short for high-density lipoprotein. Each bit of HDL cholesterol is a microscopic blob that consists of a rim of lipoprotein surrounding a cholesterol center. The HDL cholesterol particle is dense compared to other types of cholesterol particles, so it’s called high-density.
Cholesterol isn’t all bad. In fact, cholesterol is an essential fat. It provides stability in every cell of your body.
To travel through the bloodstream, cholesterol has to be transported by helper molecules called lipoproteins. Each lipoprotein has its own preferences for cholesterol, and each acts differently with the cholesterol it carries.
Experts believe HDL cholesterol may act in a variety of helpful ways that tend to reduce the risk for heart disease:
- HDL cholesterol scavenges and removes LDL — or “bad” — cholesterol.
- HDL reduces, reuses, and recycles LDL cholesterol by transporting it to the liver where it can be reprocessed.
- HDL cholesterol acts as a maintenance crew for the inner walls of blood vessels. Damage to the inner walls is the first step in the process of atherosclerosis, which causes heart attacks and strokes. HDL scrubs the wall clean and keeps it healthy
Does Coffee Increase Cholesterol
While coffee does not contain cholesterol, it can affect cholesterol levels. The diterpenes in coffee suppress the bodys production of substances involved in cholesterol breakdown, which causes cholesterol to increase. Specifically, coffee diterpenes may cause an increase in total cholesterol and LDL levels.
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How Is High Cholesterol Diagnosed
You cant tell if you have high cholesterol without having it checked. A simple blood test will reveal your cholesterol level.
Men 35 years of age and older and women 45 years of age and older should have their cholesterol checked. Men and women 20 years of age and older who have risk factors for heart disease should have their cholesterol checked. Teens may need to be checked if they are taking certain medicines or have a strong family history of high cholesterol. Ask your doctor how often you should have your cholesterol checked.
Risk factors for heart disease include:
- Cigarette smoking.
- Having an immediate family member who has had heart disease.
- Being overweight or obese.
- Inactivity.
Myth: I Cant Do Anything To Change My Cholesterol Levels
Fact: You can do many things to improve your cholesterol levels and keep them in a healthy range!
- Get tested at least every 5 years .1,2 Learn more about cholesterol screenings.
- Make healthy food choices. Limit foods high in saturated fats. Choose foods naturally high in fiber and unsaturated fats. Learn more about healthy diets and nutrition at CDCs nutrition, physical activity, and obesity website.
- Be active every day. The Physical Activity Guidelines for Americans recommends that adults get 150 to 300 minutes of moderate physical activity each week. Learn more about physical activity basics and tips.
- Dont smoke or use tobacco products. Smoking damages your blood vessels, speeds up the hardening of the arteries, and greatly increases your risk for heart disease. If you dont smoke, dont start. If you do smoke, quitting will lower your risk for heart disease. Learn more about tobacco use and ways to quit at CDCs smoking and tobacco use website.
- Talk with your health care provider about ways to manage your cholesterol if any medicines are given to you to manage your cholesterol, take them as they are prescribed. Learn more about medicines to lower cholesterol.
- Know your family history. If your parents or other immediate family members have high cholesterol, you probably should be tested more often. You could have a condition called familial hypercholesterolemia .
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Medical Guidelines And Recommendations
In 2015, the United States Department of Agriculture Dietary Guidelines Advisory Committee recommended that Americans eat as little dietary cholesterol as possible, because most foods that are rich in cholesterol are also high in saturated fat and thereby may increase the risk of cardiovascular disease. For over 2 decades, the Dietary Guidelines for Americans recommended that dietary cholesterol be no more than 300 mg per day. In a 2014 draft, DGAC dropped this recommendation because evidence showed no appreciable relationship between dietary and serum cholesterol. This caught the eye of the Physicians Committee for Responsible Medicine , which sued DGAC due to concerns of conflicts of interest which prompted the final draft to recommend eating “as little dietary cholesterol as possible”. A 2013 report by the American Heart Association and the American College of Cardiology recommended to instead focus on healthy dietary patterns rather than cholesterol limits as they are hard for clinicians and consumers to implement. They recommend the DASH and Mediterranean diet, which are low in cholesterol. A 2017 review by the American Heart Association recommends switching saturated fats for polyunsaturated fats to reduce cardiovascular disease risk.
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Can High Cholesterol Be Prevented Or Avoided
Making healthy food choices and exercising are two ways to reduce your risk of developing high cholesterol.
Eat fewer foods with saturated fats . Choose healthier fats. This includes lean meats, avocados, nuts, and low-fat dairy items. Avoid foods that contain trans fat . Look for foods that are rich in omega-3 fatty acids. These foods include salmon, herring, walnuts, and almonds. Some egg brands contain omega-3.
Exercise can be simple. Go for a walk. Take a yoga class. Ride your bike to work. You could even participate in a team sport. Aim to get 30 minutes of activity every day.
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About Your Cholesterol Result
A cholesterol test can measure:
- total cholesterol the overall amount of cholesterol in your blood, including both “good” and “bad” cholesterol
- good cholesterol this makes you less likely to have heart problems or a stroke
- bad cholesterol this makes you more likely to have heart problems or a stroke
- triglycerides a fatty substance similar to bad cholesterol
When you get your result, you may just be told your total cholesterol.
You might be able to get separate results for your good and bad cholesterol and triglycerides. Ask your doctor or nurse.
What Are The Main Roles Of Hdl Cholesterol
HDL cholesterol has a protective role against diseases of the heart and blood vessels such as heart attacks and strokes. The cholesterol itself is a fat, so its not the cholesterol that is protective, but the HDL lipoprotein as a whole.
HDL has three main effects
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Is Ldl Or Hdl Good Or Bad
HDL helps rid your body of excess cholesterol so its less likely to end up in your arteries. LDL is called bad cholesterol because it takes cholesterol to your arteries, where it may collect in artery walls. Too much cholesterol in your arteries may lead to a buildup of plaque known as atherosclerosis.
How Can I Raise My Hdl Level
If your HDL level is too low, lifestyle changes may help. These changes may also help prevent other diseases, and make you feel better overall:
- Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of bad fats. This means limiting saturated fats, which include full-fat milk and cheese, high-fat meats like sausage and bacon, and foods made with butter, lard, and shortening. You should also avoid trans fats, which may be in some margarines, fried foods, and processed foods like baked goods. Instead, eat unsaturated fats, which are found in avocado, vegetable oils like olive oil, and nuts. Limit carbohydrates, especially sugar. Also try to eat more foods naturally high in fiber, such as oatmeal and beans.
- Stay at a healthy weight. You can boost your HDL level by losing weight, especially if you have lots of fat around your waist.
- Exercise. Getting regular exercise can raise your HDL level, as well as lower your LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on most, if not all, days.
- Avoid cigarettes.Smoking and exposure to secondhand smoke can lower your HDL level. If you are a smoker, ask your health care provider for help in finding the best way for you to quit. You should also try to avoid secondhand smoke.
- Limit alcohol. Moderate alcohol may lower your HDL level, although more studies are needed to confirm that. What we do know is that too much alcohol can make you gain weight, and that lowers your HDL level.
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Myth: I Dont Need Statins Or Other Medicines For My Cholesterol I Can Manage My Cholesterol With Diet And Exercise
Fact: Although many people can achieve good cholesterol levels by making healthy food choices and getting enough physical activity, some people may also need medicines called statins to lower their cholesterol levels. Guidelinesexternal icon also suggest that other medicines in addition to statins may be needed to help control cholesterol.2
People who may need statins or other medicines to manage cholesterol levels include the following:
- People with familial hypercholesterolemia or people with very high levels of bad cholesterol. FH is a genetic condition that causes very high LDL cholesterol levels beginning at a young age. If left untreated, cholesterol levels will continue to get worse. This greatly raises the risk for heart disease, heart attack, and stroke at a young age.
- People with cardiovascular disease . People with CVD may already have narrowed arteries because of too much plaque. Medicines that lower cholesterol may help reduce the risk for heart attack or stroke.
- People with diabetes.Type 2 diabetes lowers HDL or good cholesterol levels and raises bad cholesterol levels. This combination raises your risk of heart disease and stroke.
Other groups of people may also need medicines to manage their cholesterol, including people who have a high risk for CVD. Always talk to your health care provider about the best ways to manage your cholesterol.
How High Is Too High
In the past, studies showed that lower HDL levels raise the risk of diseases of the blood vessels, while high HDL levels were protective. They suggested that the lower the HDL, the higher the risk of serious events such as heart attack and stroke, and the higher the HDL, the lower the risk. This would mean that raising HDL would lower the risk of illness.
More recent research suggests that HDL levels above 1.4mmol/L may not offer extra protection. In some cases, very high HDL could even raise the risk of serious problems such as a heart attack or stroke.
Some studies also suggest that for people with high LDL cholesterol which is now well-controlled, raising your HDL with medicines does not lower the risk of serious problems such as heart attacks.
Learn about high HDL cholesterol
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Cholesterol And Heart Disease: Understanding The Connection
For years, it had been believed that theres more or less a straight line between cholesterol and heart disease but recent research suggests that this relationship may be more complex.
A Minneapolis Heart Foundation study, published in April 2017 in the Journal of the American Heart Association, found that many people who have heart attacks donthave high cholesterol. The link between cholesterol and heart disease is weak, says Dr. Roberts, who places a large portion of the blame for the persistence of that link on pharmaceutical advertising for statin drugs. Statins dolower cholesterol levels, she says, but atherosclerosis still progresses due to factors like age, poor diet, smoking, and so on.
In addition, a review of studies of cholesterol and cardiovascular disease published in August 2015 in the American Journal of Clinical Nutrition found that no rigorous connection could be drawn between dietary cholesterol intake and the risk of CVD.
In contrast, the results of long-term research, published in September 2017 in the journal Circulation, concluded that statin use in men with high LDL cholesterol who had no other risk factors for heart disease reduced their rates of coronary heart disease death, cardiovascular death, and all-cause mortality by 28 percent over 20 years.
Furthermore, a study of more than 400,000 people published in December 2019 in The Lancet found a strong link between non-HDL cholesterol and long-term risk of cardiovascular disease.