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Know your LDLs and HDLs: What your cholesterol numbers really mean
Here’s how to read your test results, and what they can tell you about your overall health.
The next time you go for your physical examination, your doctor may order blood tests. Needles aren’t fun, but the test results can tell you a lot about your health. For one thing, you’ll learn what your cholesterol levels are.
What is cholesterol, and why is it so important? It’s a waxy substance made by your liver that circulates through your blood.1 Your body needs some cholesterol to function. For example, it helps you make vitamin D (which is good for bone health) and substances you need to digest food.1,2
Cholesterol also helps in the creation of certain hormones, including sex hormones, says cardiologist Luigi Pacifico, DO. He’s an associate professor of medicine at the University of Massachusetts Chan Medical School in Worcester.
Your body makes all the cholesterol it needs for good health. But you also get cholesterol from foods like meat and dairy products. When you have too much LDL cholesterol (the “bad” kind) in your blood, it can cause problems. The cholesterol can stick to the walls of your arteries (blood vessels that carry blood away from your heart) and clog them.3 This raises your risk of issues such as heart disease, heart attack and stroke.4
That’s why getting your cholesterol levels checked regularly can be important. But what do the numbers on your test result mean? And what are healthy cholesterol levels? Find answers to these and other important questions below.
What does a cholesterol test measure?
Let’s say you rolled up your sleeve and had some blood drawn at your doctor’s office. When your doctor sends you the test results, they’ll include:5
- LDL (low-density lipoprotein) or “bad” cholesterol. LDLs are the main source of cholesterol buildup and blockages in arteries.
- HDL (high-density lipoprotein) or “good” cholesterol. HDLs are considered “good” because they help your body get rid of LDLs.
- Total cholesterol: This is the total amount of cholesterol circulating in your blood. It is based on your LDL, HDL and triglyceride numbers.
- Triglycerides. Triglycerides are another form of fat in your blood that can raise your risk of heart disease.
The combination of high levels of triglycerides with low HDL cholesterol or high LDL cholesterol levels can increase your risk for heart attack and stroke.6
What cholesterol numbers are healthy?
The numbers below are generally considered normal for most adults, according to government guidelines.7 They are measured in milligrams per deciliter (mg/dL). Aim for:7
Total cholesterol: 200 mg/dL or less
LDL cholesterol: 100 mg/dL or less
HDL cholesterol: 40 mg/dL or higher for men (or those assigned male at birth) and 50 mg/dL or higher for women (or those assigned female at birth)
Triglycerides: Less than 150 mg/dL
But there’s not one number that every person should aim for. Your target numbers can vary, based on your health history, gender, how old you are, and other factors.
What numbers mean I have high cholesterol?
The numbers below are considered borderline high or high for most adults. Your doctor can help you understand what they mean for you.7
Total cholesterol: 200 mg/dL or higher
LDL cholesterol: 100 mg/dL or higher
- 150 to 199 (borderline high)
- 200 or higher (high)
- For women: 50 mg/dL or lower
- For men: 40 mg/dL or lower
What’s making my cholesterol so high?
There are many factors that can increase your risk for, or cause unhealthy cholesterol levels.8 Some of them you can’t control. Others you can. The big factors include:
- Lifestyle habits. A diet high in saturated fats, not getting enough exercise, stress and smoking can all raise LDL cholesterol levels.
- Health conditions, such as diabetes, being overweight and sleep apnea
- Medications you take
- Race or ethnicity
- Family history of high cholesterol
How often do I need to get my cholesterol checked?
When and how often you need to get your cholesterol checked has everything to do with your age. Here’s how it breaks down:9
- Age 19 or younger: Children and teens are recommended to have their cholesterol checked between ages 9 and 11. That should be repeated every 5 years. Children as young as 2 years old may need their cholesterol checked if they have a family history of high blood pressure, high cholesterol, heart attack or stroke.
- Age 20 to 65: Younger adults should be screened every 5 years. Men ages 45 to 65 and women ages 55 to 65 should be screened every 1 to 2 years.
- Older than 65: Older adults should be screened every year.
If you have other health risk factors, you may need to be screened more often. Your doctor might want to check your cholesterol more often if:
- You have a family history of heart disease or high cholesterol, or you have high blood pressure
- You have diabetes
- You vape, smoke or chew tobacco
If you’re not sure when you last got your cholesterol checked, ask your doctor. They can look in your records and make sure you’re up to date.
What can I do if I have high cholesterol?
Your doctor may offer some tips on how to get it to a healthier level. They may first have you use a cardiovascular risk calculator. That’s a tool, available online, that can help determine if you may need to take medication to lower your cholesterol.10
If your risk level for developing heart disease in the next 10 years is high, your doctor may recommend that you start taking medication.11 These could be statins or fibrates to lower your LDLs.12
Some risk factors you can’t control, like your age or family history. But others you can by making some lifestyle changes, such as:13
- Eating healthier
- Getting daily exercise
- Maintaining a healthy weight
- Not smoking or using tobacco products
Before you make any changes to your eating habits or exercise, be sure to talk with your doctor.
Bottom line: Knowing your cholesterol numbers is important. They can help your doctor figure out the right plan to keep you healthy. Whatever plan they choose for you, be patient. “It takes three to four months for your cholesterol numbers to change,” says Dr. Pacifico. “So be prepared for a recheck.”
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- Centers for Disease Control and Prevention. About Cholesterol. Last updated March 20 24, 2023. Accessed September 13, 2023.
- American Heart Association. What Is Cholesterol? Last updated November 6, 2020. Accessed September 13, 2023.
- Centers for Disease Control and Prevention. Cholesterol Myths and Facts. Last reviewed October 24, 2022. Accessed September 13, 2023.
- Centers for Disease Control and Prevention. Know Your Risk for Heart Disease. Last updated March 21, 2023. Accessed September 13, 2023.
- National Heart, Lung and Blood Institute. Cholesterol and Your Heart: What You Need to Know Fact Sheet. Published September 2022. Accessed September 20, 2023.
- Centers for Disease Control and Prevention. LDL and HDL cholesterol and triglycerides. Last reviewed May 16, 2023. Accessed October 4, 2023.
- National Library of Medicine. Cholesterol levels: What you need to know. Last updated October 20, 2020. Accessed October 4, 2023.
- National Heart, Lung, and Blood Institute. Blood Cholesterol: Causes and Risk Factors. Last updated March 24, 2022. Accessed September 13, 2023.
- National Heart, Lung, and Blood Institute. Blood cholesterol diagnosis. Last updated March 24, 2022. Accessed October 4, 2023.
- American College of Cardiology. ADCVD Risk Estimator Plus. Accessed September 13, 2023.
- National Library of Medicine, MedlinePlus. Heart Disease Risk Assessment. Accessed September 13, 2023.
- American Heart Association. Cholesterol Medications. Last reviewed November 11, 2020. Accessed September 13, 2023.
- Centers for Disease Control and Prevention. Prevent High Cholesterol. Last reviewed May 16, 2023. Accessed September 13, 2023.
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