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.
Hdl Cholesterol: ‘good’ Cholesterol
Not all cholesterol is bad. High-density lipoprotein cholesterol is considered “good” cholesterol because it actually works to keep the LDL, or “bad” cholesterol from building up in your arteries. The higher the HDL, the better. HDL levels of 60 mg/dL and higher can help reduce your risk for heart disease. Conversely, HDL levels of 40 mg/dL and lower are considered a high risk-factor for developing heart disease.
The Pros And Cons Of Total Cholesterol Hdl Ldl And Triglyceride Testing
Time to get your cholesterol checked. Okay, but which test should you get? It’s not so simple anymore. Here is a rundown of some of the choices and their pros and cons:
Total cholesterol. This is the simplest and least expensive test. The test doesn’t require any sophisticated lab work, either. The simple, do-it-yourself home cholesterol tests measure total cholesterol.
But total cholesterol includes both “good” high-density lipoprotein cholesterol, and the “bad” varieties, chiefly low-density lipoprotein and very-low-density lipoprotein . So, if your total cholesterol is in the desirable category, it’s possible that you may have unhealthy levels of HDL and LDL and VLDL . Think of total cholesterol as a first glimpse, a peek. Doctors are not supposed to make any treatment decisions based on this number alone.
Cholesterol levels can be lowered by stress or infection. An injury, cancer, stroke, or heart attack may have the same effect. So, if your cholesterol levels are unusually high or low, your doctor will probably want to repeat the test some weeks later. Abnormal readings may also lead to tests for other medical problems.
HDL cholesterol. HDL wins its laurels as the “good” cholesterol because it sponges up cholesterol from blood vessel walls and ferries it to the liver for disposal. In contrast, LDL deposits the harmful fat in vessel walls.
An HDL level of 60 or above is associated with a lower risk of heart disease, and below 40 is associated with a higher risk.
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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.
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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Understanding The Highs And Lows Of Cholesterol
You know that too much is dangerous. But what is cholesterol, anyway? Where does it come from? And is it all bad?
Cholesterol is a waxy substance that is found in every cell in the body. Its either made by the body or absorbed from food. Your body needs cholesterol to make important steroid hormones such as estrogen, progesterone and vitamin D. Its also used to make bile acids in the liver these absorb fat during digestion.
So some cholesterol is necessary but bad cholesterol is something you can do without. Excess bad cholesterol in the bloodstream can deposit into the bodys arteries. These deposits are called plaques and result in atherosclerosis, or hardening of the arteries. This is the major cause of heart attacks, strokes and other vascular problems.
Your total cholesterol level is a measure of the total amount of cholesterol circulating in your bloodstream, which includes several components:
- LDL cholesterol: LDL stands for low-density lipoprotein. This is known as the bad cholesterol, which directly contributes to plaque buildup in the arteries. Very low density lipoprotein, or VLDL cholesterol, is another type, which is a precursor to LDL.
- Total cholesterol is VLDL cholesterol plus LDL cholesterol plus HDL cholesterol.
- HDL cholesterol: HDL stands for high-density lipoprotein. Experts think at optimal levels it might help the body get rid of LDL cholesterol.
And guess what? This buildup can start as early as your 20s.
How Much Does The Test Cost
You may find it helpful to talk with your doctor about the costs of cholesterol testing. The cost of cholesterol testing may depend on several factors:
- What type of cholesterol test is being taken
- Whether LDL is being calculated or measured
- Insurance coverage
- Where the test is being performed
Blood testing is typically covered by insurance when prescribed by a doctor, but you may be responsible for out-of-pocket costs on copays, deductibles, or technician fees.
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Direct Measurement Of Ldl Particle Concentrations
There are several competing methods for measurement of lipoprotein particle concentrations and size. The evidence is that the NMR methodology results in a 22-25% reduction in cardiovascular events within one year,contrary to the longstanding claims by many in the medical industry that the superiority over existing methods was weak, even by statements of some proponents.
Since the later 1990s, because of the development of NMR measurements, it has been possible to clinically measure lipoprotein particles at lower cost and higher accuracy. There are two other assays for LDL particles, however, like LDL-C, most only estimate LDL particle concentrations.
Direct LDL particle measurement by NMR was mentioned by the ADA and ACC, in a 28 March 2008 joint consensus statement, as having advantages for predicting individual risk of atherosclerosis disease events, but the statement noted that the test is less widely available, is more expensive ]. Debate continues that it is “…unclear whether LDL particle size measurements add value to measurement of LDL-particle concentration”, though outcomes have always tracked LDL particle, not LDL-C, concentrations.
The LDL particle concentrations are typically categorized by percentiles, < 20%, 2050%, 50th80th%, 80th95% and > 95% groups of the people participating and being tracked in the MESA trial, a medical research study sponsored by the United States National Heart, Lung, and Blood Institute.
How Can A High Ldl Level Raise My Risk Of Coronary Artery Disease And Other Diseases
If you have a high LDL level, this means that you have too much LDL cholesterol in your blood. This extra LDL, along with other substances, forms plaque. The plaque builds up in your arteries this is a condition called atherosclerosis.
Coronary artery disease happens when the plaque buildup is in the arteries of your heart. It causes the arteries to become hardened and narrowed, which slows down or blocks the blood flow to your heart. Since your blood carries oxygen to your heart, this means that your heart may not be able to get enough oxygen. This can cause angina , or if the blood flow is completely blocked, a heart attack.
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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.
What Affects Cholesterol Levels
There are a variety of factors that can affect cholesterol levels. Some risk factors are within your control, while others are not:
- Genetics: These factors include familial hypercholesterolemia and a family history of heart disease.
- Sex: Males often have higher levels of LDL. After menopause, a woman’s LDL levels can also increase.
- Weight: People who are overweight or obese are at increased risk of having high cholesterol.
- Sedentary lifestyle: Lack of physical activity can increase the risk of overweight and obesity and, in turn, increase cholesterol levels.
- Diet: Overall diet quality can affect cholesterol in a negative way, including eating too many saturated and trans fats and not enough fiber.
- Age: Your body’s ability to clear cholesterol can be impacted as you age.
- Race and ethnicity: There are different rates of high cholesterol based on race/ethnicity and sex, with the highest rates among males in Hispanics and the highest rates among females in non-Hispanic Whites.
- Smoking: Smoking can increase your bad cholesterol and lower your good cholesterol.
- Other medical conditions: Having a previous history of high cholesterol, heart disease, or diabetes can increase your risk of developing high cholesterol.
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Taking Time To Stay Active
If a person is not at a moderate weight or has obesity, they may have an increased risk of high LDL cholesterol. If a person is not very active and has a high body mass index , they may need to increase their activity levels.
Adults should aim to complete 150 minutes of physical activity a week. A weekly routine may include 30 minutes of exercise over 5 days. A person could try cardio, for example, such as brisk walking or running. Muscle-strengthening activities such as hill walking or resistance weight training may also help with maintaining moderate weight levels.
No Apparent Danger Of Very Low Ldl Cholesterol
LDL is a key component of many hormones and all cell membranes, which allow cells to communicate with each other. Earlier studies had raised concerns that lowering LDL too far might interfere with normal cellular functions, especially in organs that have higher lipid concentrations, such as the brain and reproductive organs. And there have been reports of a slightly increased risk of osteoporosis and brain bleeding in patients treated with high doses of statin medications.
Well-known side effects in people who use statin medications include muscle aches and a slightly increased risk of diabetes, especially when high doses of medication are used. Whether these risks are due to the statin medications themselves or the lowering of LDL is not entirely clear.
However, people with rare inherited disorders in which LDL levels are extremely low from birth appear to have normal fertility and no major organ dysfunction. Therefore, an extremely low LDL by itself does not appear to be dangerous in these unusual cases.
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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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Ldl Cholesterol: How Low Can You Go
- By Dara K. Lee Lewis, MD, Contributor
Elevated low-density lipoprotein cholesterol is a clearly established risk factor for the development of cardiovascular disease . Lowering LDL with medications and/or lifestyle changes has been shown to lower CVD risk. Just how far to lower LDL, however, has remained controversial.
Current guidelines developed by the American Heart Association, American College of Cardiology, and several other professional organizations recommend lowering elevated LDL levels to 70 milligrams per deciliter in people with high-risk CVD. However, recent studies have suggested that CVD risk may continue to drop as LDL is lowered beyond these targets, leading some cardiologists to believe that our current guidelines are not aggressive enough. Others are concerned that lowering LDL too much may lead to harm.
Cholesterol Levels For Adults
- Total cholesterol levels less than 200 milligrams per deciliter are considered desirable for adults. A reading between 200 and 239 mg/dL is considered borderline high and a reading of 240 mg/dL and above is considered high.
- LDL cholesterol levels should be less than 100 mg/dL. Levels of 100 to 129 mg/dL are acceptable for people with no health issues but may be of more concern for those with heart disease or heart disease risk factors. A reading of 130 to 159 mg/dL is borderline high and 160 to 189 mg/dL is high. A reading of 190 mg/dL or higher is considered very high.
- HDL levels should be kept higher. A reading of less than 40 mg/dL is considered a major risk factor for heart disease. A reading from 41 mg/dL to 59 mg/dL is considered borderline low. The optimal reading for HDL levels is of 60 mg/dL or higher.
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What Does The Term Total Cholesterol Mean
The term total cholesterol refers to the total amount of the different kinds of cholesterol in your blood. One kind of cholesterol is the LDL cholesterol. Another kind is the HDL cholesterol. LDL stands for low-density lipoprotein. LDL is the bad cholesterol. HDL stands for high-density lipoprotein. HDL is the good cholesterol.
Cholesterol Chart For Adults
According to the 2018 guidelines on the management of blood cholesterol published in the Journal of the American College of Cardiology , these are the acceptable, borderline, and high measurements for adults.
All values are in mg/dL and are based on fasting measurements.
Your doctor may recommend a plan of treatment for high cholesterol that includes lifestyle modifications and potentially medication. This will vary based on factors like other medications you may be taking, your age, sex, and general health.
Here are some medications more commonly prescribed for high cholesterol:
Medications can also be used to treat contributing factors to cholesterol like triglycerides. These may be used in addition to some of the medications above.
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