Why High Cholesterol Matters
High cholesterol puts you at risk for heart disease and stroke, leading causes of death in the U.S. High levels of LDL cholesterol can contribute to plaque buildup on the walls of the arteries, narrowing the arteries and restricting blood flow. If some of this plaque breaks off and gets stuck in a narrowed artery, it can block the artery and cut off blood supply to the heart or brain, resulting in heart attack or stroke.
Ldl Cholesterol: ‘bad’ Cholesterol
Low-density lipoprotein cholesterol, often referred to as “bad” cholesterol, is the type that tends to deposit on the walls of the arteries. White blood cells combine with the LDL cholesterol, forming artery-narrowing plaque, which restricts blood flow. The optimal level of LDL cholesterol for most people is 100 mg/dL or lower. If you have heart disease, you may need to strive for LDL levels of 70 mg/dL or lower.
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Getting A Cholesterol Test
A blood sample is taken that will be used to determine the amount of bad cholesterol , good cholesterol and other fatty substances in your blood.
You may be asked not to eat for 10-12 hours before the cholesterol test, usually including when you’re asleep at night. This ensures that all food is completely digested and won’t affect the outcome of the test.
Your GP or practice nurse can carry out the cholesterol test and will take a blood sample, either using a needle and a syringe or by pricking your finger.
A newer type of test that measures non-high-density lipoprotein is now sometimes used because it’s thought to be a more accurate way of estimating cardiovascular disease risk than LDL.
Non-HDL cholesterol is total cholesterol minus HDL cholesterol. It’s also not necessary to fast before the test, so it is more convenient.
Medication May Be Needed
For some people, diet and lifestyle changes are not enough. High blood cholesterol levels often have a genetic component. Some people inherit altered genes that cause high cholesterol and this cannot usually be changed sufficiently by lifestyle or diet.
If you are at risk of coronary heart disease and your LDL cholesterol level doesnt drop after scrupulous attention to diet, your doctor may recommend medications to force your blood LDL levels down. Cell cholesterol levels, however, remain normal, so lowering blood cholesterol has no effect on most cell metabolic processes.
Some people get muscle aches from statins, which are the most commonly used medication to lower blood cholesterol. However, diet and exercise will still be important, even if you are taking medication. Your doctor may also refer you to a specialist who treats cardiovascular disease.
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What Do Your Triglyceride Results Mean
Triglycerides are another type of blood fat and your triglyceride levels can tell you more about your health. If your triglycerides are high, it can mean youre at risk of heart disease, liver disease and diabetes.
You might have your triglycerides tested when you have a cholesterol test.
People with high triglyceride levels often have a low HDL level as well, which is an unhealthy combination.
How Does This Ldl Calculator Work
This health tool computes the LDL cholesterol value from the total cholesterol, HDL, triglyceride levels according to the two formulas used in these cases: the Friedewald and Iranian study . The second formula is often recommended when the triglyceride levels are lower than average, as in the case of those with a low carbohydrate diet.
For your convenience, the LDL calculator allows you to enter the three values in either mg/dL or mmol/L . You will be given the two results in the corresponding measurement unit so that you can further on interpret the results easily.
In case of the 1st tab “LDL in mg/dL” these are the equations used:
– The Friedewald formula: LDL = TC – HDL TG / 5.0
– The Iranian study formula: LDL = TC / 1.19 + TG / 1.9 HDL / 1.1 38
In case of the 2nd tab “LDL in mmol/L” these are the formulas behind the algorithm:
– The Friedewald equation: LDL = TC – HDL TG / 2.17
– The Iranian study method: LDL = TC / 1.19 + TG / 0.81 HDL / 1.1 0.98
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When Should My Cholesterol Levels Be Tested
Your GP may recommend that you have your blood cholesterol levels tested if you:
- have been diagnosed with coronary heart disease, stroke or mini stroke , or peripheral arterial disease
- have a family history of early cardiovascular disease
- have a close family member who has a cholesterol-related condition
- are overweight
Testing Your Blood Cholesterol
Your serum cholesterol is measured with a simple blood test. A doctor draws blood from your arm enough to fill one or more little vials. The blood samples are sent to a lab for analysis. Before your blood draw youll need to fast for at least eight hours.
A healthy adult should have a blood test that includes a serum cholesterol check every four to six years. As you get older, your doctor may advise you to have your cholesterol, and other markers of health like your blood pressure, checked every year. This is especially true if you have risk factors for cardiovascular disease. These factors include:
- family history of heart disease
If you start a new medication or change medications meant to manage your cholesterol, youll probably have more frequent cholesterol checks. Serum cholesterol tests can show whether the medication is working.
It usually takes several days or even a few weeks to get your blood test results back. Your lab report will show your serum cholesterol levels in milligrams per deciliter . Your serum cholesterol includes:
- LDL level
- HDL level
- 20 percent of your triglyceride level
The lower the LDL level and the higher the HDL level, the better. LDL is the type of cholesterol that forms waxy plaque on the inside wall of an artery. Too much plaque can limit blood flow through that artery.
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Heres what you should look for in your results:
|healthy serum cholesterol|
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How To Lower Cholesterol: Low
Low-carbohydrate diets may help improve HDL cholesterol levels. The National Institutes of Health conducted a study that found while both low-fat and low-carb dieters lost weight over the two-year study period, low-carb dieters also improved their HDL cholesterol levels. The problem with low-carb diets is that they may be difficult to adhere to. Consult your doctor about the best healthy eating plan to manage your cholesterol.
What Are The Cholesterol Targets
Your doctor will decide your target levels based on your risk factors for cardiovascular disease. Following are average targets. Note that your doctor will decide what is best for you.
Ideal LDL cholesterol level: Less than 3.0 mmol/L
Ideal HDL: Above 1.0 mmol/L
If you are at low risk: LDL cholesterol should be less than 5.0 mmol/L and total cholesterol HDL-C ratio should be less than 6.0
If you are moderate risk: Your LDL cholesterol should be less than 3.5 mmol/ and total cholesterol HDL-C ratio should be less than 5
If you are high risk: Your LDL cholesterol should be less than 2.0 mmol/L and total cholesterol HDL-C ratio should be less than 4.0. An HDL cholesterol level of less than 1.0 mmol/L means youre at higher risk for heart disease.
If you have diabetes: LDL should be less than 2.0 mmol/L.
If you have had a heart attack: Your LDL should be less than 2.0 mmol/L.
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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!
Who Should Be Tested
Your GP may recommend that you have your blood cholesterol levels tested if you:
- have been diagnosed with coronary heart disease, stroke or mini-stroke , or peripheral arterial disease
- are over the age of 40 people over 40 should have their estimate of CVD risk reviewed regularly
- have a family history of early cardiovascular disease for example, if your father or brother developed heart disease or had a heart attack or stroke before the age of 55, or if your mother or sister had these conditions before the age of 65
- have a close family member who has a cholesterol-related condition, such as familial hypercholesterolaemia
- are overweight or obese
- have high blood pressure or diabetes
- have another medical condition, such as kidney disease, an underactive thyroid, or an inflamed pancreas these conditions can cause increased levels of cholesterol or triglycerides
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The Best Cholesterol Risk Indicator
So to summarise, weve seen that your risk of heart disease will be lower if your blood sugars are lower. While stabilising your blood sugars is an essential first step , delaying your meals until your blood sugars are lower using Data-Driven Fasting may be more helpful.
If your blood sugars are elevated in the morning, then theres a good chance you are above your Personal Fat Threshold and need to lose some body fat. Once your blood sugars after meals start to stabilise, you should focus on high satiety, nutrient-dense foods and meals to help you continue to reduce your body fat, which will, in turn, reduce your fasting blood sugar levels.
Another Type Of Fat Found In The Blood Mainly From The Food We Eat
Whats healthy? Less than 1.7 mmol/L ideally on a fasting sample, or less than 2.3 mmol/L on a non-fasting sample.
What should I do? Very high triglyceride levels can cause a painful condition called pancreatitis. People can have raised levels for many reasons, but the most common reasons are lifestyle-related:
- Being apple-shaped .
- Developing or having type 2 diabetes.
Excessive alcohol consumption.
You can keep your triglyceride levels low by losing weight, being more active and eating sensibly, especially by cutting back on alcohol, sugary foods and saturated fats, and eating more fruits, vegetables, pulses and wholegrains.
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What Are The Symptoms Of High Cholesterol
Lifestyle factors include:
- an unhealthy diet– eating too much saturated fat is thought to increase levels of LDL or bad cholesterol
- lack of exercise – this can also increase your levels of LDL
- obesity – being overweight often means you also have higher levels of LDL cholesterol and triglycerides, and a lower level of the good HDL.
- drinking too much alcohol
- smoking – if you smoke, a chemical in cigarettes called acrolein stops the good HDL from moving fatty deposits to your liver
- kidney disease
- transient ischaemic attack – or a mini stroke
- peripheral arterial disease
How Is The Total Cholesterol Or Blood Cholesterol Test Done
A blood test is a routine test. A phlebotomist is the person whose job it is to draw blood. Blood is usually drawn from the vein in your arm. You will sit down and the phlebotomist will wrap a rubber band around your upper arm so that the vein in your elbow sticks out. Then they will use a needle to puncture the vein and remove blood. The blood is sent to the lab to be examined.
Youve probably been at health fairs where testing is offered. In that case, the person performing the test takes a drop of blood from your finger. The finger stick test uses a small blade to poke a hole in the tip of your finger to get the blood.
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How Is High Cholesterol Diagnosed
A blood test, specifically a lipid panel or lipid profile, will show your total cholesterol levels.
The measured total cholesterol level is made up of your LDL cholesterol, HDL cholesterol and 20% of triglycerides .
For an accurate reading, you should not eat or drink anything between nine and twelve hours before the sample is taken.
In Australia, cholesterol levels are measured in millimoles per litre .
The range below is a guide for a healthy blood cholesterol level.
- Total cholesterol should be between: 3.9 5.5 mmol/L
- HDL should be between: 0.9 2.1 mmol/L
- LDL should be between: 1.7-3.5 mmol/L
- Triglycerides should be between: 0.5 1.7 mmol/L
This is one of the key checks that we do on the mobile Heart Health Check Tour, along with checking your blood pressure and sugar levels. This visual cholesterol guide is also available as a PDF to .
Cholesterol Levels For Men And Women
HDL levels differ for men and women
Women naturally have higher HDL cholesterol levels than men due to differences in the genes. Women should aim for an HDL cholesterol level above 1.2mmol/L while men should aim for above 1mmol/L.
Cholesterol levels can rise during pregnancy
During pregnancy, both cholesterol and triglyceride levels can significantly rise. We don’t recommend getting a cholesterol test during pregnancy because your results won’t be accurate. Our advice is to wait until at least 6-8 weeks after your baby is born or after you stop breastfeeding to get a cholesterol test. This means you don’t need to worry unnecessarily. Find out more about pregnancy and blood fats.
Cholesterol levels rise during the menopause
Women may also find their cholesterol levels rise during the menopause.
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Safe Blood Cholesterol Levels
Health authorities recommend that cholesterol levels should be no higher than 5.5 mmol per litre if there are no other risk factors present. If there are other cardiovascular risk factors such as smoking and high blood pressure or pre-existing cardiovascular disease, then the aim for the LDL levels would be less than 2 mmol/l. Approximately half of all adult Australians have a blood cholesterol level above 5 mmol/l. This makes high blood cholesterol a major health concern in Australia.
How Low Should We Decrease Ldl
The association between blood cholesterol and cardiovascular disease has been consistently demonstrated in epidemiological studies within all ranges of studied cholesterol levels.1 Statins have been the mainstay therapy for low-density lipoprotein-cholesterol reduction and subsequent prevention of CV events. In fact, after the first year of statin use, each 1 mmol/L of reduction in LDL-C leads to a 20-25% relative reduction of global CV risk, including a 20% decrease in coronary mortality.2,3
Whereas this degree of relative risk reduction is largely independent of baseline characteristics,2,4,5 the net benefit or absolute risk reduction achieved with lowering LDL-C levels is highly dependent on baseline CV risk. As an example, a reduction in LDL-C of 1 mmol/L and subsequent 25% relative reduction in CV risk will translate into 1% versus 5% absolute risk reduction in patients with a 10-year estimated risk of 4% and 20%, respectively. For this reason, guidelines across the globe recommend CV risk assessment and tailoring the aggressiveness of lipid lowering therapies to such risk.6-10
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When Should I Get My Cholesterol Checked
How often you have your cholesterol level checked depends on your age, family history and what other risk factors for heart disease you have.
If you have no cardiovascular risk factors, routine screening most often starts at the age of 40 for men and 50 for women.
If your cholesterol is up, as with an FH diagnosis, your family doctor can also advise you when to have follow-up cholesterol levels done.
What Does This Mean For My Dietary Choices
The common theme in all of this is that we just dont do well when we mix high levels of fat and carbs. Its not necessarily the fat or the carbs, but rather the combination of the two in the diet and the bloodstream that becomes problematic!
When we combine fat+carbs in ways that rarely occur in nature, we get cholesterol and glucose hanging around together in our bloodstream for extended periods, which leads to oxidised LDL and eventually heart disease.
In nature, fat, carbs and protein tend to oscillate with the seasons. Before modern agriculture and food processing, we wouldnt have had access to high levels of carbs and fat at the same time.
We see the same pattern with carb intake vs satiety. Its not necessarily the high carb or low carb diet that is problematic, but rather the combination of carbs+fat that leads us to eat more than we need, which causes our body fat stores to be overfull and with a subsequent overflow of high levels of energy into our bloodstream . In our modern food environment, the combination of non-fibre carbs with fat with minimal protein drives us to eat more than we otherwise would.
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