The "Good” Cholesterol vs. "Bad” Cholesterol
When you receive your results from a cholesterol test, you will see several numbers such as total cholesterol, LDL and HDL along with several cholesterol ratios. One of these may be the ratio of HDL/LDL.
Cholesterol does not dissolve into the bloodstream. It is transported to and from the cells by carriers called lipoproteins. Low-density lipoprotein, or LDL, is what is called “bad” cholesterol. High-density lipoprotein, or HDL, is known as "good" cholesterol. These, along with triglycerides and Lp(a) cholesterol, comprise your total cholesterol count, as shown in a blood test.
HDL Cholesterol (the Good)
Nearly a quarter to a third of blood cholesterol is carried by high-density lipoprotein (HDL). HDL is called “good” cholesterol, due to the fact that higher levels of HDL appear to protect against heart attacks. Low levels of HDL can increase the risk of heart disease. Medical experts believe that HDL carries cholesterol away from the arteries and returns it to the liver, where it's passed from the body. Studies show that HDL removes excess cholesterol from arterial plaque and slowing its buildup.
LDL Cholesterol (the Bad)
When too much LDL (bad) cholesterol is in the bloodstream, it can accumulate in the inner walls of the arteries that supply blood to the heart and brain. Together with other substances, it may form plaque, hard deposits that can constrict arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms in the bloodstream, it may be blocked in a narrowed artery, resulting in a heart attack or stroke.
Triglycerides (the Ugly)
Triglyceride is a type of fat that is made in the body. High levels of triglycerides may be due to being overweight or obese, lack of physical activity, cigarette smoking, excess consumption of alcohol or a diet excessively high in carbohydrates (over 60 percent of total calories). Those with elevated triglycerides frequently have a high total cholesterol level, with a high LDL level and a low HDL level. Many of those with heart disease and/or diabetes also have high levels of triglyceride.
Lp(a) is a genetic variation of LDL cholesterol. A higher level of Lp(a) is a major risk factor for the increase of fatty deposits in arteries. Lp(a) is not completely understood, but it could interact with substances found on the walls of the artery and add to the buildup of fatty deposits.
The ratio of HDL/LDL is the ratio of good (HDL) to bad cholesterol (LDL). The ratio is established by dividing the LDL into the HDL. So, if one has an HDL cholesterol reading of 50 mg/dL and an LDL of 150 mg/dL, the HDL/LDL ratio would be 0.33. The goal is to maintain the ratio above 0.3, with the best HDL/LDL ratio being above 0.4.
It is estimated that over a hundred million adults in America have total blood cholesterol counts of 200 mg/dL and higher, and of these about a third of adults have levels of 240 or higher. For adults, total cholesterol levels of 240 mg/dL or greater are considered to be high risk. Levels from 200 to 239 mg/dL are considered to be borderline-high risk.
Your doctor must interpret your cholesterol numbers based on other risk factors such as age, gender, exercise, family history, smoking and high blood pressure.
Some risk factors which will help your doctor determine your ideal cholesterol counts include:
• Previous heart attack
• Men over 44 years of age
• Women over 55 years of age
• Women during menopause or after menopause
• Parent or sibling with a history of heart disease
• Cigarette smoking
• High blood pressure
• Overweight or obese
All adults 20 years of age and older should have their cholesterol tested every five years. If your cholesterol level is high or if you have other risk factors for heart disease, you may need to have it checked sooner and more often.
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