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| Your total cholesterol is in this range | |
| Your HDL is less than 40 mg/dL | |
| You don’t have other risk factors for heart disease |
You should also lower your intake of foods high in saturated fat and cholesterol to reduce your cholesterol level to below 200. Your doctor may order another blood test to measure your LDL cholesterol. Ask your doctor to discuss your LDL cholesterol with you. Even if your cholesterol is between 200 and 239 mg/dL, you may not be at high risk for a heart attack. Some people, such as women before menopause, and young, active men who have no other risk factors, may have high HDL cholesterol and desirable LDL levels. Ask your doctor to interpret your results. Everyone's case is different.
High risk
If your total cholesterol level is 240 or more, it's definitely high.
Your risk of heart attack and, indirectly, of stroke is greater. You need more
tests. Ask your doctor for advice. About 20 percent of the U.S. population has
high blood cholesterol levels.
Your LDL cholesterol level greatly affects your risk of heart attack and, indirectly, of stroke. The lower your LDL cholesterol, the lower your risk. In fact, it’s a better gauge of risk than total blood cholesterol. Your LDL cholesterol will fall into one of these categories:
Desirable -- less than 130 mg/dL
Borderline high risk -- 130-159 mg/dL
High risk -- 160 mg/dL or higher
The key point to remember is, the lower your LDL cholesterol, the lower your risk. Your doctor may prescribe a diet low in saturated fat and cholesterol, regular exercise and a weight management program if you're overweight. If you can't lower your cholesterol with these efforts, medications may also be prescribed to lower your LDL cholesterol. Check these categories and the goals for treatment that can lower your risk of heart attack.
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LDL Level
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Goal
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| People without coronary heart disease and with fewer than two risk factors |
190 mg/dL or higher*
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160 mg/dL or lower
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| People without coronary heart disease and with two or more risk factors |
160 mg/dL or higher
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130 mg/dL or lower
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| People with coronary heart disease |
130 mg/dL or higher**
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100 mg/dL or lower
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*In men less than 35 years of age and premenopausal women with LDL cholesterol levels of 190 to 219 mg/dL, drug therapy should be delayed except in high-risk patients such as those with diabetes.
**In coronary heart disease patients with LDL cholesterol levels of 100 to 129 mg/dL, the doctor should consider whether to initiate drug treatment in addition to the American Heart Association Step 2 Diet.
If you do not know if you have other risk factors for heart disease, check out the American Heart Association's list by clicking here.
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. HDL cholesterol that';s less than 40 mg/dL is low. Low HDL cholesterol puts you at high risk for heart disease. Smoking, being overweight and being sedentary can all result in lower HDL cholesterol. If you have low HDL cholesterol, you can help raise it by:
| Not smoking | |
| Losing weight (or maintaining a healthy weight) | |
| Being physically active for at least 30-60 minutes a day on most days of the week. |
People with high blood triglycerides usually have lower HDL cholesterol and a higher risk of heart attack and, indirectly, of stroke. Progesterone, anabolic steroids and male sex hormones (testosterone) also lower HDL cholesterol levels. Female sex hormones raise HDL cholesterol levels.
The American Heart Association recommends that the absolute numbers for total blood cholesterol and HDL cholesterol levels be used. They are more useful to the physician than the cholesterol ratio in determining the appropriate treatment for patients.
Total blood cholesterol is the most common measurement of blood cholesterol. It is the number you normally receive as test results. Cholesterol is measured in milligrams per deciliter of blood (mg/dL). Knowing your total blood cholesterol level is an important first step in determining your risk for heart disease. However, a critical second step is knowing your HDL or "good" cholesterol level.
Some physicians and cholesterol technicians use the ratio of total cholesterol to HDL cholesterol in place of the total blood cholesterol.
The ratio is obtained by dividing the HDL cholesterol level into the total cholesterol. For example, if a person has a total cholesterol of 200 mg/dL and an HDL cholesterol level of 50 mg/dL, the ratio would be stated as 4:1. The goal is to keep the ratio below 5:1; the optimum ratio is 3.5:1.
Your triglyceride level will fall into one of these categories:
| Triglyceride Level | Classification |
| Less than 150 mg/dL | Normal |
| 150-199 mg/dL | Borderline-high |
| 200-499 mg/dL | High |
| 500 mg/dL or higher | Very high |
Many people with high triglycerides have underlying diseases or genetic disorders. If this applies to you, the main therapy is to change your lifestyle. This includes controlling your weight, eating foods low in saturated fat and cholesterol, exercising regularly, not smoking and, in some cases, drinking less alcohol. People with high triglycerides may also need to limit their intake of carbohydrates to no more than 45–50 percent of total calories. The reason for this is that carbohydrates raise triglycerides and lower HDL cholesterol. Use products with monounsaturated and polyunsaturated fats.
As
a rule, women have higher HDL cholesterol levels than men. The female sex
hormone estrogen tends to raise HDL cholesterol, which may help explain why
premenopausal women are usually protected from developing heart disease.
Estrogen production is highest during the childbearing years. Women also tend to
have higher triglyceride levels. Triglyceride levels range from about 50 to 250
mg/dL, depending on age and sex. As people get older, more overweight or both,
their triglyceride and cholesterol levels tend to rise.
Hormone replacement therapy (HRT) may benefit some women with osteoporosis or other medical conditions associated with menopause. Women with a personal or family history of breast cancer or other endocrine-related cancers should not receive HRT. The HERS trial in women who had previously had a heart attack showed that these women did not benefit from HRT. Recent clinical trials appear to confirm that HRT does not appear to reduce risk of cardiovascular disease and stroke in post menopausal women.
The American Heart Association recommends the use of statins as the first line of drug therapy for women with heart disease. This should be combined with a low-fat, low-cholesterol diet, weight management and regular exercise. Statin drugs are very effective for lowering LDL cholesterol levels and have few immediate short-term side effects. They work by interrupting the formation of cholesterol from the circulating blood.
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