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Get Your Cholesterol Checked

Even though high cholesterol may lead to serious heart disease, most of the time there are no symptoms. This is why it is important to have your cholesterol levels checked by your doctor.

To reduce your risk of heart disease and stroke, work with your health care professionals to monitor and maintain healthy cholesterol levels. Even if your cholesterol levels are good now, it's not too early to develop healthy habits that can help keep your numbers in check.

How is cholesterol tested?

A small sample of blood will be drawn from your arm. If your doctor has ordered other tests to be run at the same time as your cholesterol test, all the samples will usually be taken at the same time. Your blood sample is then analyzed by a laboratory.

Your doctor will tell you if you should fast (avoid consuming food, beverages and medications, usually for nine to 12 hours) before your blood test. If you aren't fasting when the blood sample is drawn, only the values for total cholesterol and HDL cholesterol will be usable. That's because the amount of LDL (bad) cholesterol level and triglycerides can be affected by what you've recently consumed.

Your test report will show your cholesterol level in milligrams per deciliter of blood (mg/dL). Your doctor must interpret your cholesterol numbers based on other risk factors such as age, family history, smoking and high blood pressure.

Your LDL (bad) cholesterol levels will be needed to determine your treatment plan if your total cholesterol is 200 mg/dL or greater, or if your HDL is less than 40 mg/dL. If you weren't fasting for your first test, your doctor may need to send you for another test.

How often should I have my cholesterol checked?

The American Heart Association endorses the National Cholesterol Education Program (NCEP) guidelines for detection of high cholesterol: All adults age 20 or older should have a fasting lipoprotein profile - which measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides - once every five years. This test is done after a nine- to 12-hour fast without food, liquids or pills. It gives information about total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. You may need to have your cholesterol checked more often than every five years if one or more of these situations applies to you:

  • Your total cholesterol is 200 mg/dL or more.
  • You are a man over age 45 or a woman over age 50.
  • Your HDL (good) cholesterol is less than 40 mg/dL.
  • You have other risk factors for heart disease and stroke.

What do my cholesterol levels mean?

Total Cholesterol Level Category
Less than 200 mg/dL Desirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dL or higher raises your risk.
200 to 239 mg/dL Borderline high
240 mg/dL and above High blood cholesterol. A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL.
HDL Cholesterol Level Category
Less than 40 mg/dL
(for men)
Low HDL cholesterol. A major risk factor for heart disease.
Less than 50 mg/dL
(for women)
60 mg/dL and above High HDL cholesterol. An HDL of 60 mg/dL and above is considered protective against heart disease.

With HDL (good) cholesterol, higher levels are better. Low HDL cholesterol (less than 40 mg/dL for men, less than 50 mg/dL for women) puts you at higher risk for heart disease. In the average man, HDL cholesterol levels range from 40 to 50 mg/dL. In the average woman, they range from 50 to 60 mg/dL. An HDL cholesterol of 60 mg/dL or higher gives some protection against heart disease. The mean level of HDL cholesterol for American adults age 20 and older is 54.3 mg/dL.

Smoking, being overweight and being sedentary can all result in lower HDL cholesterol. To raise your HDL level, avoid tobacco smoke, maintain a healthy weight and get at least 30-60 minutes of physical activity more days than not.

People with high blood triglycerides usually also have lower HDL cholesterol and a higher risk of heart attack and stroke. Progesterone, anabolic steroids and male sex hormones (testosterone) also lower HDL cholesterol levels. Female sex hormones raise HDL cholesterol levels.

The lower your LDL cholesterol, the lower your risk of heart attack and stroke. In fact, it's a better gauge of risk than total blood cholesterol. In general, LDL levels fall into these categories:

LDL Cholesterol Level Category
Less than 100 mg/dL Optimal
100 to 129 mg/dL Near or above optimal
130 to 159 mg/dL Borderline high
160 to 189 mg/dL High
190 mg/dL and above Very high

Your other risk factors for heart disease and stroke help determine what your LDL level should be, as well as the appropriate treatment for you. A healthy level for you may not be healthy for your friend or neighbor. Discuss your levels and your treatment options with your doctor to get the plan that works for you. The mean level of LDL cholesterol for American adults age 20 and older is 115.0 mg/dL.

Triglycerides

Triglyceride is the most common type of fat in the body. Many people who have heart disease or diabetes have high triglyceride levels. Normal triglyceride levels vary by age and sex. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol seems to speed up atherosclerosis (the buildup of fatty deposits in artery walls). Atherosclerosis increases the risk for heart attack and stroke.

Triglyceride Level Category
Less than 150 mg/dL Normal
150-199 mg/dL Borderline high
200-499 mg/dL High
500 mg/dL and above Very high

Many people have high triglyceride levels due to being overweight/obese, physical inactivity, cigarette smoking, excess alcohol consumption and/or a diet very high in carbohydrates (60 percent or more of calories). High triglycerides are a lifestyle-related risk factor; however, underlying diseases or genetic disorders can be the cause. The mean level of triglycerides for American adults age 20 and older is 144.2 mg/dl.

The main therapy to reduce triglyceride levels is to change your lifestyle. This means control your weight, eat a heart-healthy diet, get regular physical activity, avoid tobacco smoke, limit alcohol to one drink per day for women or two drinks per day for men and limit beverages and foods with added sugars. Visit your health care provider to create an action plan that will incorporate all these lifestyle changes. Sometimes, medication is needed in addition to a healthy diet and lifestyle.

A triglyceride level of 150 mg/dL or higher is one of the risk factors of metabolic syndrome. Metabolic syndrome increases the risk for heart disease and other disorders, including diabetes.

Above content provided by The American Heart Association in partnership with Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted September 2010

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Contact Information

CardioVascular Institute at
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
888-99-MYCVI
617-632-9777

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