Understanding Your Cholesterol Levels

By Dianne Lange. Medically reviewed by Tom Iarocci, MD. May 7th 2016

One of the most important things you can do for a healthier heart is to get your cholesterol tested regularly. Just as important is actually remembering your cholesterol numbers and what they mean. While many people may get tested regularly, they often don’t know how to interpret the results.

If you don’t remember what your cholesterol levels were the last time you had a blood test, you’ve got company. According to a study published in the American Journal of Cardiology, about 40 percent of U.S. adults are not aware of their cholesterol numbers.

“There is worldwide data now proving that high cholesterol is directly linked to heart disease,” says Vincent J. Bufalino, M.D., cardiologist and spokesperson for the AHA. An expert on cardiovascular disease and stroke prevention, he explains that in order to determine how your cholesterol levels affect your risk of heart disease, your doctor will also take into account other risk factors like age, family history and whether you smoke or have high blood pressure.


Cholesterol, he says, isn’t all bad. This waxy substance is used by the body for energy and to make vital chemicals like hormones and bile. There’s even a “good” type of cholesterol, of which higher numbers are better. However, “bad” cholesterol can accumulate in arteries, forming a plaque that may cause heart attack and stroke. For heart health, the idea is to boost your “good” cholesterol, minimize your “bad” cholesterol and aim for a total of less than 200.

Who should get their cholesterol tested?

If you’re 20 years old or older and healthy, the AHA recommends getting your cholesterol checked every five years. In the near future, testing will likely start at a younger age due to the increasing rate of obesity and diabetes — both of which are risk factors for high cholesterol — in young people.


“A screening blood test at age 10 or 15 is now being strongly considered [by the AHA],” says Bufalino. One thing to understand about general recommendations, he adds, is that they don’t apply to everyone. In the U.S., cholesterol levels are reflected in milligrams of cholesterol per deciliter of blood, or mg/dL. Based on previous blood tests and other factors, you may need to be tested more often if any of the following apply to you:

  • Your previous total cholesterol was 200 mg/dL or more.
  • You’re a man over age 45 or a woman over age 50.
  • Your HDL (good) cholesterol is too low: less than 40 mg/dL for men and less than 50 mg/dL for women.
  • You have other risk factors for heart disease or stroke, such as a family history of cardiovascular disease or high blood pressure.

Furthermore, a lot can happen within five years. Say, you start smoking, gain weight, take on a high-pressure job — all of this can change your cholesterol numbers and increase your risk of stroke and heart disease.

“The majority of folks with normal cholesterol levels still need a cholesterol check once a year and at least every two years,” says Bufalino.

Taking a cholesterol test

When getting your cholesterol tested, you can expect to be assessed in a standard fasting lipoprotein panel, which simply means taking the test after 9 to 12 hours of not drinking or eating anything. Here are the numbers you’ll receive:

  • Total cholesterol: This umbrella measurement includes both good and bad cholesterol. A normal level is helpful to know, but it isn’t necessarily an indicator of good health. And ideal total cholesterol number is less than 200 mg/dL.
  • Low-density lipoprotein cholesterol (LDL-C): This “bad” or unhealthy lipoprotein dumps cholesterol into your arteries and tissues. And ideal LDL level is less than 130 mg/dL.
  • High-density lipoprotein cholesterol (HDL-C): This “good” or healthy lipoprotein carries cholesterol out of the blood and to the liver for removal. And ideal HDL level is more than 50 mg/dL for women and more than 40 mg/dL for men.
  • Triglycerides: This is the most common type of fat in the body. Triglyceride measurement is covered in a lipid panel since people with high triglycerides — combined with low good cholesterol and high bad cholesterol — are at greater risk for heart attack and stroke. An ideal triglycerides level is less than 150 mg/dL.

Take the next steps

If your numbers are good, congratulations. But what should you do if your numbers are less than ideal?

“Exercise more, reduce daily stressors and lose weight,” advises Bufalino.

  • For some patients, exercise and better nutrition aren’t enough to improve their numbers. That’s when statin drugs can really make a difference. However, they should be prescribed only for those whose particular risk factors and/or lipid measurements warrant them. Other medications that benefit people with high triglycerides include niacin, omega-3 oils and fiber. The right combination of drugs — both prescription and over the counter —depends on your own numbers. Consult with your physician for the best plan to fit your unique cholesterol needs.
  • Know your risk factors. If you or someone you love suffers from diabetes, insulin resistance, heart disease or a combination of several other risk factors, also ask your health care practitioner to complete an advanced lipid panel. If you aren’t in a higher-risk category, at least realize when you’re due for an annual checkup, and get your cholesterol tested.

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