Understanding cholesterol levels

Blood cholesterol test is a very common test to assess the risk of heart attack. The doctor measures the levels of good and bad cholesterol in your blood to arrive at a conclusion about your risk for heart attack. But how does the doctor arrive at a conclusion? What does he check? Which parameter is the best indicator of risk of heart diseases? These are some of the questions that even doctors have deliberated at times.

Who should get a cholesterol check?
It is universally accepted that people below 40 should get a cholesterol check at least every five years, if not more frequently. It is known as lipoprotein profile. This includes cholesterol HDL LDL level, amount of low-density lipoprotein, amount of high-density lipoprotein, and triglycerides.

What are the optimal parameters of blood cholesterol?
Total cholesterol of less than 200 mg/dL is good, but your total cholesterol HDL LDL level may not be within the desirable range. For LDL cholesterol, the optimal level is less than 100 mg/dL, and for HDL or good cholesterol, it is more than 60. Similarly, for triglycerides, the optimal level is less than 150.

Cholesterol ratio
Doctors are now emphasizing on cholesterol ratio than individual cholesterol numbers. You too can calculate your cholesterol ratio by dividing your total cholesterol number by your HDL number. A ratio of 3.5-to-1 is considered to be an optimal ratio. A higher ratio translates to a higher risk of heart disease.

Total cholesterol
Testing of total cholesterol is easy, and you don’t need to fast for this. This includes both good, i.e., HDL cholesterol and bad, i.e., LDL cholesterol. HDL stands for high-density lipoprotein, and LDL stands for low-density lipoprotein. The optimal number of total cholesterol that indicates a healthy heart is below 200. But since total cholesterol is a combination of LDL and HDL, a good number for total cholesterol may not indicate a good number for HDL or a good number for LDL. So, even if your total cholesterol HDL and LDL is in a healthy range, your HDL and LDL may or may not be in a healthy range individually. This is why total cholesterol is not considered to be an absolute indicator of risk of heart problems.

LDL cholesterol
LDL is considered to be the bad guy in cholesterol measurement. A high number of LDL increases the risk of heart attack. The most desirable level for LDL is 70 mg/dL. LDL can be measured directly as a variable in a non-fasting blood sample.

For testing LDL, you need to fast for about 12 hours. This is needed since triglyceride level may shoot up after a meal and distort the measurement. If you are alcoholic, then you should stay away from it for at least 24 hours before the test.

HDL cholesterol
HDL helps in the destruction of LDL. An HDL level of 60 or more is considered to be good, and a level of 40 or less is considered to be dangerous for the person.

Non-HDL cholesterol
You can get your non-HDL cholesterol number by subtracting HDL cholesterol level from total cholesterol level. This contains all the harmful cholesterol. A level of less than 130 mg/dL is considered to be an optimal level for non-HDL cholesterol. If you get a higher number, you are at risk of heart disease.

Ratio of total cholesterol to HDL
The ratio of total cholesterol to HDL is considered to be a measure of risk for heart diseases. Low total cholesterol to HDL is considered good since this indicates that the total quantity of HDL in total cholesterol is high. On the other hand, a high ratio of total cholesterol to HDL indicates that the quantity of HDL in total cholesterol is not significant.

LDL-HDL ratio
An LDL-HDL ratio can be obtained simply by dividing the number for LDL with the number obtained for HDL. A lower ratio indicates that the amount of HDL is substantial in comparison to the amount of LDL. This is good for your heart. On the other hand, a higher ratio indicates that the amount of HDL is not significant in comparison to the amount of LDL. This may not be good for your heart.