August 12, 2021
Good cholesterol, bad cholesterol, HDL, LDL. Which number should be high; which should be low? It can be confusing.
Here’s what you need to know about the relationship between cholesterol and heart disease, and how you can reduce your risk.
HDL and LDL: What Do They Mean?
LDL (low-density lipoprotein) is one of two lipoproteins that carry cholesterol in your blood. LDL is known as “bad cholesterol” since it can build up dangerously on the walls of your arteries. Lower LDL is desirable.
On the other hand, HDL (high-density lipoprotein) is called the “good cholesterol” because it actually cleanses your blood of excess cholesterol. Higher HDL is desirable.
Cholesterol is a waxy substance your body needs to stabilize your body’s cells. The value of HDL is that it:
- Removes LDL cholesterol and takes it back to the liver where it’s reprocessed.
- Helps keep the inner walls (endothelium) of your blood vessels clean. Damage to these walls is the first step to coronary artery disease.
Cholesterol Guidelines from the CDC
The Centers for Disease Control and Prevention (CDC) offers the following guidelines to help people understand the results of their cholesterol test:
- Total cholesterol. Less than 200 mg/dL is considered normal.
- LDL cholesterol. Less than 100 mg/dL is considered normal. LDL is sometimes called “bad” cholesterol, because it can build up and clog your arteries, eventually leading to heart disease or stroke.
- HDL cholesterol. It is best to have more than 40 mg/dL. HDL is sometimes called “good” cholesterol, because it can help clear arteries of cholesterol build up.
- Triglycerides. This is a type of fat in the blood. Normal levels are typically less than 150 mg/dL.
How to Maintain a Healthy Lifestyle
A heart-healthy lifestyle is at the core of treating high cholesterol and lowering your risk for cardiovascular disease.
- Eat a diet low in saturated fats, trans fat, and sodium.
- Make sure you diet includes fruits, vegetables, whole grains, low-fat dairy, poultry, fish, legumes, nontropical vegetable oils, and nuts.
- Limit sweets, sugar-sweetened beverages, and red meats.
- Get regular aerobic exercise – 30 to 60 minutes on most days.
- Maintain healthy body weight.
- Don’t smoke.
- Control elevated blood pressure and diabetes.
Talk to Your Doctor About Statin Therapy
Recommendations for drug therapy focus treatment on those adults who are most likely to obtain the greatest benefit. The decision to take statins (Lipitor, Zocor, Crestor) should come after careful discussion with your doctor who understands your personal medical history and can help you weigh the risks and benefits. Generally, statins are recommended if you:
- Have cardiovascular disease or are at high risk for heart disease.
- Have an LDL level > 189.
- Have diabetes and an LDL level between 70 -- 189.
For everyone else, the guidelines say, statins should be considered if the risk of a heart attack or stroke in the next 10 years is at least 7.5 percent. A new risk calculator will help you and your doctor figure that out, using factors such as blood pressure, age, and total cholesterol levels.