Cholesterol
Maintain a Desirable Cholesterol Level
If results of a blood test show that you have an elevated cholesterol level, you have an increased risk of heart disease. If you haven't had your cholesterol checked recently, please have it checked!
What is cholesterol?
Cholesterol is a normal part of your blood. It is a yellow waxy substance that can be obtained from food we eat (exogenous) and that is made by our liver (endogenous). Cholesterol is essential to our body. Among other things, it makes cell membranes and hormones. Excess cholesterol causes changes in the walls of the arteries in the heart and other areas of the body. These develop into plaque. Plaque causes narrowing in the blood vessels. We refer to this narrowing as "obstructive coronary artery disease."
Researchers are now discovering that cholesterol plaques are particularly troublesome, since they may rupture and cause a complete blockage and heart attack. Some coronary artery narrowings may not be considered appropriate for bypass surgery or other invasive techniques because the arteries may be too small or not easily accessible. But even these narrowings in the coronary arteries may cause heart attacks. Since it is not appropriate to use invasive techniques to widen such arteries, the best alternative is to control cardiac risk factors.
What are the different types of cholesterol I keep hearing about?
When you have your blood checked for cholesterol, your physician orders a "lipid profile." Cholesterol is one type of lipid or fat in your body. Triglycerides are another type of fat. Both cholesterol and triglycerides need a protein package to carry them in the bloodstream (since both of them do not dissolve in water). The combination of fat and protein is called a lipoprotein.
The main types of lipoproteins are low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL).
- LDL is considered the "bad" cholesterol. Its function
is to transport cholesterol to sites throughout the body
for use in repairing cell membranes. Excess LDL cholesterol
in the bloodstream causes changes in the walls of the arteries.
- HDL is the good guy. It carries excess cholesterol
back to the liver where it is altered and removed from the
body. The higher the HDL, the less likely there is excess
cholesterol to alter the walls of arteries. Exercise increases
the amount of HDL in the blood.
- VLDL is a precursor of LDL and is not factored as a risk factor for heart disease. It seems to correspond to a high triglyceride level.
What should my cholesterol be to reduce my risk of heart disease?
The lipid profile, which is done in a fasting state, gives information about the total cholesterol level, HDL and LDL levels, triglycerides as well as a ratio. All numbers need to be looked at to assess overall cardiovascular risk.
| Lipid Levels and Coronary Risk | |||
| Item Measured | Level (mg/dl) | ||
Desirable* |
Borderline |
Too high |
|
| Total cholesterol | and lt;200 |
200-239 |
and gt;240 |
| LDL cholesterol | and lt;100 |
100-159 |
and gt;160 |
| HDL cholesterol | and gt;35 |
35-45 |
and lt;35 |
| Triglycerides | and lt;150 |
||
| Total cholesterol/ HDL ratio | Men:
and lt;5 |
||
*For adults without known heart disease. The goal for adults with heart disease is an LDL and lt; 100 mg/dl.
