Types of Cholesterol

HDL
As you may already know, not all cholesterol is “bad” cholesterol. HDL is known as the “good” cholesterol because the more HDL you have, the less your risk for heart disease. Your body makes HDL to carry excess cholesterol away from the arteries to your liver, where it is removed from the body. A healthy level of HDL for women is above 50 mg/dL and for men above 40 mg/dL. Anything lower than these levels puts you at a greater risk for developing heart disease. Women have naturally higher HDL levels than men because estrogen, a female sex hormone, tends to raise HDL cholesterol. For this reason, post-menopausal women are at a greater risk of developing high cholesterol, and consequently heart disease, than pre-menopausal women. Smoking, being overweight and being physically inactive can lead to low HDL cholesterol.

< 40 mg/dL		Poor
40–59 mg/dL		Better
≥ 60 mg/dL		Best

LDL
LDL is the most important number used in determining your risk for heart attack and stroke. The general rule is the lower your LDL, the less likely you are to develop heart disease. LDL is considered “bad” cholesterol because in high levels it can clog your arteries, which can lead to heart attack and stroke. When too much LDL circulates in your bloodstream, it can start to build up along the innermost walls of your arteries. Together with other fats, cellular debris, calcium, platelets and fibrin (a natural clotting material in the blood), built-up LDL forms plaque along the artery wall. When this happens, it is referred to as a condition called atherosclerosis.

The danger of atherosclerosis is that it reduces the diameter of the arteries, which means there’s less space for blood to flow through. In addition to added strain on your heart, the result is less blood circulating throughout your body, which means a decreased supply of oxygen. Not enough oxygen to your heart can cause a heart attack, while insufficient oxygen to your brain leads to stroke. And if your arms and legs don’t get enough oxygen, you can develop gangrene. Another danger is that plaque can become dislodged from the artery wall and form into a blood clot, which can cause both heart attack and stroke. Smoking and high blood pressure increase your risk for atherosclerosis.

The good news is that your LDL cholesterol is largely controllable. By eating a healthy diet low in saturated fat, exercising regularly and not smoking, most people can keep their LDL at a healthy level. A healthy LDL level differs according to your risk for coronary heart disease. To determine your heart disease risk, take the quiz located on pages 8-12 in the Guide to Lowering You Cholesterol. For most people, an LDL below 100 mg/dL is ideal. An LDL of 130 mg/dL is borderline high, and anything above 159 mg/dL is considered high.

< 70 mg/dL		Optimal for people at high risk for heart disease
< 100 mg/dL		Optimal for people at risk for heart disease
100–129 mg/dL		Near optimal
130–159 mg/dL		Borderline high
160–189 mg/dL		High
≥ 190 mg/dL		Very high

Triglycerides
Triglyceride is a form of fat that your body produces and that also comes from certain foods. Unlike LDL and HDL, only a small portion of triglyceride is found in the bloodstream. Most triglycerides are stored in fat tissue. Alone, high triglycerides do not cause atherosclerosis (buildup of cholesterol and other substances on artery walls), but some triglyceride-rich lipoproteins also contain cholesterol. This kind of lipoprotein can lead to plaque buildup and eventually heart disease. High triglycerides also frequently coincide with low HDL, high total cholesterol and an increased risk for diabetes. It is important that you maintain a triglyceride level below 150 mg/dL.

If you have high triglycerides, it may originate from an underlying disease or a genetic disorder. Even if this is the case, the main line of treatment is making healthy lifestyle changes. This means maintaining an ideal weight; eating healthy food that’s low in saturated fat, trans fat and cholesterol; participating in some form of physical activity at least 30 minutes each day; not smoking; and limiting your alcohol intake. Some doctors may even restrict your intake of carbohydrates, as there is evidence that carbohydrates may raise triglyceride levels and lower HDL in some people. Also, women tend to have higher triglyceride levels than men.

< 150 mg/dL		Desirable
150–199 mg/dL		Borderline high
200–499 mg/dL		High
≥ 500 mg/dL		Very high