How to interpret Cholesterol Results; What is Total Cholesterol, LDL, HDL, and Triglycerides and how are they used or important in determining a person’s Heart Disease Risk.
Hyperlipidemia (High Cholesterol) refers to increased levels of lipids (fats) in the blood, including cholesterol and triglycerides. Although hyperlipidemia does not cause a person to feel bad, it can significantly increase the risk of coronary heart disease. People with coronary heart disease develop thickened or hardened arteries in the heart muscle. This can cause chest pain, a heart attack, or both. Hyperlipidemia is also associated with an increased risk of Stroke or Cerebral Vascualar Disease. Because of these heart disease and stroke risks of hyperlipidemia, treatment is often recommended for people with hyperlipidemia.
Many patients want to know "What are the components of a Lipid Panel/Cholesterol Test and what does each individual component mean?"
LIPID TYPES - There are many different types of lipid/cholesterol particles. Blood tests can determine levels of the most commonly measured components. The standard lipid blood tests include a measurement of total cholesterol, LDL and HDL cholesterol, and triglycerides.
Total cholesterol - An elevated total cholesterol level is associated with an increased risk of coronary heart disease. A desirable total cholesterol level is usually less than 200 mg/dL (5.17 mmol/L). A total cholesterol level of 200 to 239 mg/dL (5.17 to 6.18 mmol/L) is borderline high, while a value greater than or equal to 240 mg/dL (6.21 mmol/L) is high. However, most decisions about treatment are made based upon the level of LDL or HDL cholesterol, and a patient's additional risk factors (for example, presence of Diabetes) rather than the level of total cholesterol.
LDL stands for low density lipoprotein cholesterol - The LDL cholesterol (sometimes called "bad cholesterol") is a more accurate predictor of coronary heart disease than total cholesterol. Higher LDL cholesterol concentrations are associated with an increased chance of coronary heart disease in many studies. Most physicians prefer to measure LDL cholesterol after the person has fasted (not eaten) for 12 to 14 hours.
People with hyperlipidemia should know their own LDL cholesterol level, as well as their target or ideal LDL level. This goal depends upon several factors, including the person's history of coronary heart disease and their 10-year risk score of developing coronary heart disease (see below Calculator link)
Triglycerides - High triglyceride levels are also associated with an increased risk of coronary heart disease. Triglyceride levels are divided as follows:
Triglycerides should be measured after fasting for 12 to 14 hours.
HDL cholesterol - Not all cholesterol is bad. Elevated levels of high density lipoprotein cholesterol or HDL cholesterol actually lower the risk of heart disease. In fact, a very high HDL (greater than or equal to 60 mg/dL or 1.55 mmol/L) is considered a negative risk factor for coronary heart disease (removes one risk factor). On the other hand, treatment is sometimes recommended for people with low levels of HDL cholesterol (< 40 mg/dL or 1.03 mmol/L), particularly if they already have heart disease.
CHOLESTEROL SCREENING GUIDELINES - A number of groups have created guidelines for cholesterol screening. The guidelines differ in their recommendations concerning the recommended age to start screening, the time interval between screenings, and the age at which screening may stop.
The United States Preventive Services Task Force recommends the following:
Calculating your 10 year risk of developing coronary heart disease -Your 10-year risk can often be calculated by a number of online calculators, and one such URL link is provided below. The best calculators ask an individual to enter their age, total cholesterol, HDL level, smoking status, and systolic blood pressure value (the upper number of the two BP numbers), and whether or not they take medication for Hypertension or control of blood pressure. The one below is in English.
http://hp2010.nhlbihin.net/atpiii/calculator.asp
POSSIBLE TREATMENT AND WHERE TO GET MORE INFORMATION - Your healthcare provider is the best source of information for questions and concerns related to your medical problem. Because no two people are exactly alike and recommendations can vary from one person to another, it is important to seek guidance from a doctor who is familiar with your individual situation.
Hyperlipidemia (High Cholesterol) refers to increased levels of lipids (fats) in the blood, including cholesterol and triglycerides. Although hyperlipidemia does not cause a person to feel bad, it can significantly increase the risk of coronary heart disease. People with coronary heart disease develop thickened or hardened arteries in the heart muscle. This can cause chest pain, a heart attack, or both. Hyperlipidemia is also associated with an increased risk of Stroke or Cerebral Vascualar Disease. Because of these heart disease and stroke risks of hyperlipidemia, treatment is often recommended for people with hyperlipidemia.
Many patients want to know "What are the components of a Lipid Panel/Cholesterol Test and what does each individual component mean?"
LIPID TYPES - There are many different types of lipid/cholesterol particles. Blood tests can determine levels of the most commonly measured components. The standard lipid blood tests include a measurement of total cholesterol, LDL and HDL cholesterol, and triglycerides.
Total cholesterol - An elevated total cholesterol level is associated with an increased risk of coronary heart disease. A desirable total cholesterol level is usually less than 200 mg/dL (5.17 mmol/L). A total cholesterol level of 200 to 239 mg/dL (5.17 to 6.18 mmol/L) is borderline high, while a value greater than or equal to 240 mg/dL (6.21 mmol/L) is high. However, most decisions about treatment are made based upon the level of LDL or HDL cholesterol, and a patient's additional risk factors (for example, presence of Diabetes) rather than the level of total cholesterol.
LDL stands for low density lipoprotein cholesterol - The LDL cholesterol (sometimes called "bad cholesterol") is a more accurate predictor of coronary heart disease than total cholesterol. Higher LDL cholesterol concentrations are associated with an increased chance of coronary heart disease in many studies. Most physicians prefer to measure LDL cholesterol after the person has fasted (not eaten) for 12 to 14 hours.
People with hyperlipidemia should know their own LDL cholesterol level, as well as their target or ideal LDL level. This goal depends upon several factors, including the person's history of coronary heart disease and their 10-year risk score of developing coronary heart disease (see below Calculator link)
Triglycerides - High triglyceride levels are also associated with an increased risk of coronary heart disease. Triglyceride levels are divided as follows:
Normal - less than 150 mg/dL (1.69 mmol/L)
Borderline high - 150 to 199 mg/dL (1.69 to 2.25 mmol/L)
High - 200 to 499 mg/dL (2.25 to 5.63 mmmol/L)
Very high - greater than 500 mg/dL (5.65 mmol/L)
HDL cholesterol - Not all cholesterol is bad. Elevated levels of high density lipoprotein cholesterol or HDL cholesterol actually lower the risk of heart disease. In fact, a very high HDL (greater than or equal to 60 mg/dL or 1.55 mmol/L) is considered a negative risk factor for coronary heart disease (removes one risk factor). On the other hand, treatment is sometimes recommended for people with low levels of HDL cholesterol (< 40 mg/dL or 1.03 mmol/L), particularly if they already have heart disease.
CHOLESTEROL SCREENING GUIDELINES - A number of groups have created guidelines for cholesterol screening. The guidelines differ in their recommendations concerning the recommended age to start screening, the time interval between screenings, and the age at which screening may stop.
The United States Preventive Services Task Force recommends the following:
Cholesterol screening should start at age 35 in men and age 45 in women. Those at risk for coronary heart disease should be treated based upon the results of their screening test.
Screening is recommended at a younger age (age 20 to 35 in men and 20 to 45 in women) for people with known risk factors for heart disease. These include people with diabetes, a family history of heart disease in male relatives before age 50 or in female relatives before age 60, a family history of hyperlipidemia, or a personal history of multiple heart disease risk factors (examples; smoking, high blood pressure)
The optimal time interval between screenings is uncertain; reasonable options include every five years, with a shorter interval for those with high-normal lipid levels and longer intervals for low-risk individuals with low or normal levels.
There is no recommendation to stop screening at a particular age.
Screening may be appropriate in older people who have never been screened, although screening a second or third time is less important in older people because lipid levels are less likely to increase after age 65.
Calculating your 10 year risk of developing coronary heart disease -Your 10-year risk can often be calculated by a number of online calculators, and one such URL link is provided below. The best calculators ask an individual to enter their age, total cholesterol, HDL level, smoking status, and systolic blood pressure value (the upper number of the two BP numbers), and whether or not they take medication for Hypertension or control of blood pressure. The one below is in English.
http://hp2010.nhlbihin.net/atpiii/calculator.asp
POSSIBLE TREATMENT AND WHERE TO GET MORE INFORMATION - Your healthcare provider is the best source of information for questions and concerns related to your medical problem. Because no two people are exactly alike and recommendations can vary from one person to another, it is important to seek guidance from a doctor who is familiar with your individual situation.