Firstly What Is Cholesterol
Cholesterol is an essential type of fat that’s carried in the blood.
All cells in the body need cholesterol it’s an essential part of cell walls in our bodies and has important roles, including to produce some hormones, maintain healthy nerve cells and in the synthesis of vitamin D.
Your body needs a small amount of cholesterol to function, but an imbalance between different types of cholesterol in the blood increases the risk of heart disease, one of the leading chronic diseases in Australia today.
About ¾ of the cholesterol in your body is made in the liver and a small amount may come from the food you eat. Various factors affect blood cholesterol levels including your diet and lifestyle, body weight and genes.
Bad Cholesterol Numbersldl Is Your Enemy
As we mentioned above, HDLs job is to eliminate LDL, or low density lipoprotein. LDL is what builds up in artery walls, causing plaque and leading to heart disease and potential stroke. So those are the bad cholesterol numbers. As you might have guessed, we want these numbers to be as low as possible. The lower your LDL, the lower your risk of heart disease. Its not a direct correlation, as there are other factors including CRP levels, homocysteine and triglycerides, but generally speaking, the lower your LDL the better.
So what should those numbers be? The recommendations for LDL are much more specific than those for HDL. Anything less than 100 mg/dL is considered optimal. Up to about 129 mg/dL is close to ideal. Once you get to about 130 and above thats when it is considered high. If you are above 190 thats very high and is considered a risk.
Its interesting to note that if your LDL levels are high, it can be balanced out by high HDL levels. So its not so bad of you have elevated LDL concentrations if you have optimal HDL concentrations to counteract that. Thats why the cholesterol ratio is the most important number to look at.
We tend to focus on the total cholesterol number, i.e. anything over 200 mg/dL is considered a higher riskbut this number has become much less important as doctors are recognizing the importance of the concentrations of LDL and HDL, and not just the total amount.
What Is A Healthy Normal Cholesterol Level In The Uk
Your cholesterol level is measured in units called millimoles per litre of blood, often shortened to mmol/L.
It is recommended that healthy adults should have a total cholesterol level below 5 mmol/L. In the UK, three out of five adults have a total cholesterol level of 5 mmol/L or above, and the average cholesterol level is about 5.7 mmol/L, which can be a risk factor in the development of coronary heart disease.
However, its important to remember that as well as your cholesterol level, other factors such as smoking and high blood pressure are risk factors for the development of coronary heart disease.
The total cholesterol level includes LDL and HDL . The risk of coronary heart disease is particularly high if you have a high level of LDL cholesterol and a low level of HDL cholesterol. Individual levels of LDL and HDL cholesterol will vary and your doctor will be able to give you specific advice based on your own results.
In the UK, components of cholesterol are measured in units called millimoles per litre of blood . As a guide, these are the values healthy adults should aim for
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Causes Of Changing Cholesterol Levels
Your cholesterol levels will change as you age, most likely increasing. There are a number of causes for changing cholesterol levels. They include:
If you eat foods high in saturated fat and cholesterol, it will make your total cholesterol level rise. The saturated fat is the main cause. This type of fat comes mainly from animal food products. You can find it in meat, dairy products, chocolate, baked goods, deep-fried foods, and processed foods. These foods make up a typical American diet, and consuming a lot of these foods is cautioned against.
Weight and physical activity
If you are overweight, your risk for heart disease increases and so do your cholesterol levels. Not being physically active also contributes to a risk for heart disease and high cholesterol levels. Exercising daily and losing weight can help lower your bad cholesterol, LDL, and increase your good cholesterol, HDL.
Smoking can lower your good cholesterol, HDL, making it harder for your body to remove cholesterol from your arteries.
Age and gender
As you age, your total cholesterol levels increase. Women have lower total cholesterol levels than men of the same age. But when a woman goes through menopause, her bad cholesterol, LDL, tends to rise.
Does Age Make A Difference To Recommended Cholesterol Levels
No, recommended cholesterol levels do not change based on age. It was once thought that high cholesterol becomes less of a problem as one ages. However, there is now good evidence that lowering high cholesterol is of benefit even in the elderly.
Previously, there was also concern that some cholesterol-lowering drugs like statins may interfere with ones cognitive function and that this might be more of an issue in the elderly. This has now been debunked. Nevertheless, it is worth starting with a low dose and gradually increasing to avoid any potential side effects.
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Good Cholesterol Numbershdl Is Your Friend
When you hear someone talking about good cholesterol, they are referring to HDL, or high density lipoprotein. Lipoproteins are simply complexes that carry fat around the body. HDLs job is to go around the body looking for bad cholesterol, or LDL which we will get to shortly. Once it finds LDL, it removes it from the bloodstream and brings it to the liver to be processed.
So HDLs job is to clear out the LDL. So think of HDL as Batman and LDL is the Joker, the Riddler, the Penguin and all of their cronies. Every day your bodys supply of HDL is fighting the LDL in an ongoing battle for cardiovascular health.
So when people talk about good cholesterol numbers, they mean the amount of HDL in your bloodstream. So what is the ideal amount of HDL? Anything over 60 mg/dL is considered good. In general, it should be over 40 for men, and over 50 for women. Anything less than that is considered a risk for heart disease.
Now lets take a look at HDLs arch enemy
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.
Why Cholesterol Matters For Women
Erin Donnelly Michos, M.D., M.H.S.
Ah, cholesterol and triglycerides. We hear about them all the time. Even foods that might seem good for you on the surface, like fruit-filled yogurt or bran muffins, can contribute to abnormal levels if they contain too much saturated fat or refined sugar, says Erin Michos, M.D., associate director of preventive cardiology at the Ciccarone Center for the Prevention of Heart Disease.
Whats more, many women are at risk for high cholesterol and dont realize it. Approximately 45 percent of women over the age of 20 have a total cholesterol of 200 mg/dl and above, which is considered elevated but a survey by the American Heart Association found that 76 percent of women say they dont even know what their cholesterol values are, Michos says.
Scarier still: Triglycerides, a type of blood fat typically measured alongside cholesterol, are even more risky in women compared with men. This is a problem because womens cholesterol levels can fluctuate quite a bit after menopause and tend to increase with age, putting us at greater risk of heart disease and stroke. Knowing your cholesterol numbers and how to control them is a big step toward staying healthy.
Whats A Healthy Cholesterol Level
- LDL cholesterol for adults should be below 100 mg/dL.
- HDL cholesterol for men should be over 40 mg/dL.
- HDL cholesterol for women should be over 50 mg/dL.
- Total cholesterol should be between 125 and 200 mg/dL.
Cholesterol levels typically increase with age, which means that it becomes increasingly important to monitor cholesterol levels and take steps to manage your cholesterol as you get older.
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What Are Cholesterol Levels
- LDL cholesterol is often referred to as “bad” cholesterol because too much of it can build up in your arteries and form plaques, which increases the risk of heart disease .
- HDL cholesterol is often referred to as “good” cholesterol as it carries cholesterol to the liver to be broken down and excreted.
Since your total cholesterol is a combination of your LDL cholesterol and your HDL cholesterol, ideally you want to keep your LDL levels low and your HDL levels high. There are many factors that can influence your cholesterol, including, diet, exercise, weight, genetics, and other health conditions.
What Should My Total Cholesterol Level Be
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
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What Do Your Cholesterol Results Mean
When you have a cholesterol test, it is really important that your healthcare professional explains the results to you to prevent unnecessary worry and confusion.
Its not just your total cholesterol thats important and your results will include different types of cholesterol. If you are only given your total cholesterol, ask for a break-down of the other numbers. Its possible to have a healthy total cholesterol number but an unhealthy balance of the different types of cholesterol.
As a minimum, you should be given your total cholesterol and HDL numbers, then you can work out your ratio of total cholesterol to HDL cholesterol .
You might also have your triglycerides tested, these are another type of blood fat which are linked to heart disease.
Ask for a print out of your results if you are not able to speak to your GP, nurse or pharmacist.
Your results should include:
- Total cholesterol
This is sometimes written as ‘serum cholesterol’ or ‘TC’ and refers to your overall level of cholesterol.
- Non-HDL cholesterol
- HDL cholesterol
- TC:HDL ratio
You might be given a TC:HDL ratio, which is the ratio of HDL compared to the total cholesterol. If not, you can work it out from your HDL and total cholesterol numbers. This should be as low as possible. Above 6 is considered high.
How Often To Get Tested
According to the Centers for Disease Control and Prevention , most healthy adults should get their cholesterol checked every four to six years.
Your risk factors also determine how often your cholesterol should be checked. Adults who have a history of high cholesterol, heart disease, diabetes, or obesity need more frequent readings, as do all adults as they age.
Children should have their cholesterol checked at least once between the ages of 9 and 11 and again between 17 and 20 years of age. If a child has a family history of high cholesterol, heart disease, or is overweight or obese, their pediatrician may recommend getting checked sooner and more often.
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Find Out Your Heart Age With The Heart Age Tool
Once you have your cholesterol results you can work out your risk of developing heart disease over the next 10 years using the NHS Heart Age Tool. You will get a more accurate result if you know your blood pressure numbers too. The heart age tool is designed for people aged 25 to 84.
Adults age 40-74 are also invited for NHS Health Checks which includes other simple tests to look at your heart health.
Your Total Cholesterol Figure Divided By The Hdl
Whats healthy? The lower this figure, the better. Ideally 4.5, while above 6 is considered high risk.
What should I do? This reading will help your GP work out whether your overall cholesterol levels are healthy, which in turn helps them calculate your risk of CVD – another reason why its important to have full cholesterol results, not just TC. It could be high if your TC, LDL-C and non-HDL cholesterol levels are too high, or if your HDL-C is too low, or a combination of both. Maintaining a healthy TC:HDL ratio long-term can help reduce your risk of CVD in future. You can do this by following the advice above.
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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.
What Levels Are Normal And When Are They Too High
“Its normal for cholesterol levels to rise slightly as you get older and women tend to have higher HDL than men. In the UK, the average total cholesterol level is 5.7mmol/l.” – Dr Zenon Andreou
“Its normal for cholesterol levels to rise slightly as you get older and women tend to have higher HDL than men. In the UK, the average total cholesterol level is 5.7mmol/l.”
There are two main types of lipoprotein:
- High-density good lipoprotein this type carries cholesterol away from the cells and back to the liver to be broken down or passed away as a waste product.
- Low-density bad lipoprotein takes cholesterol to the cells where its needed. If there is more LDL than needed, it can build up in the artery walls.
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How Are Cholesterol Tests Results Used
Your doctor will make a treatment recommendation based on your level of heart disease risk. Guidelines do not use a single cholesterol level to determine treatment options.
- If you already have coronary heart disease with symptoms such as chest pain or a previous heart attack, taking medication to reduce your low density lipoprotein cholesterol is very beneficial and possibly life-saving.
- If you have been hospitalized due to heart attack or stroke, you will start treatment before you leave the hospital. The latest 2018 cholesterol guidelines recommend using a high-intensity statin , such as higher doses of rosuvastatin or atorvastatin to get cholesterol levels below 70 mg/dL. You will be encouraged to follow a heart-healthy diet, exercise, lose weight and stop smoking, if needed.
- If you do not have a diagnosis of heart disease but your cholesterol levels are high, your doctor will look at your other risk factors, and may determine your 10-year risk of cardiac disease. Usually, lifestyle changes like a healthy diet and exercise are implemented for the first 6 to 12 months. Diet and exercise can drop cholesterol levels by roughly 10 percent.
When Should You Contact Your Healthcare Provider About Your Cholesterol Levels
In truth, your healthcare provider will probably talk to you about your numbers first. As always, contact your provider if you have any new or worsening pain or other uncomfortable feelings. Make sure you know what medications you take and what they are expected to do. Call the provider if you have a reaction to the medicine.
Before you go to the office, and after you have had a cholesterol test, it helps to have a list of questions prepared about your test results and any proposed treatment.
A note from Cleveland Clinic
When considering cholesterol numbers, its important to remember that you really have the ability to make those numbers go in your favor. What you choose to eat, how much you are able to move and how you deal with lifes ups and downs are things that you can influence.
Last reviewed by a Cleveland Clinic medical professional on 07/31/2020.
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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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