Vital Things Doctors Say Everyone Should Know About Cholesterol

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  1. Total cholesterol is only part of the picture.
    When you get your bloodwork results back, there’s a good chance you focus on your total cholesterol, zeroing in on that one number. However, Dr. Mattina says what’s more important than total cholesterol is understanding each of the different components that make up that score. “You really have to break down the different types of cholesterol to get a full picture,” says Dr. Mattina. A typical cholesterol test will measure the following:

LDL: This is considered the “bad” cholesterol because it leads to plaque buildup in your arteries and increases your risk for heart attack and stroke. (The more buildup, the stiffer and narrower your arteries and the harder it is for blood to flow freely to and from the heart.) For the general population, less than 100 is ideal, and a score above 160 is considered high. However, if you’ve already been diagnosed with heart disease, you’ll want your LDL to be lower than 70—and possibly even lower, adds Randal Thomas, MD, medical director of the Mayo Clinic’s Cardiac Rehabilitation Program.
HDL: This is considered the “good” cholesterol because it carries LDL cholesterol away from the arteries and back to the liver, where it’s broken down and flushed from the body. For men, the ideal range is between 40 and 100 HDL; for women, 50 to 100 is ideal, says Dr. Thomas
Triglycerides: This is a type of fat in the blood that your body uses for energy. For most people, a triglyceride score above 150 is considered high, says Dr. Thomas, and above 1,000 is dangerously high. The combo of high triglycerides with low “good” HDL cholesterol or high “bad” LDL cholesterol can boost your risk for heart attack and stroke.
To get a more accurate picture of how your cholesterol may be putting you at risk for heart disease, add all three of these cholesterol components and then subtract your HDL number. “That number tells us how many particles of cholesterol are circulating that put you at risk,” says Dr. Mattina. (Per the CDC’s guidelines, you’ll want this number to be 250 mg/dL or lower.)

  1. Even if you have normal cholesterol levels, you can have a heart attack.
    For women, in particular, the new thinking is that it’s not just cholesterol particles that convey the risk of heart disease, but how that cholesterol behaves, says Dr. Mattina. “Many people with normal cholesterol numbers have heart attacks, and that’s likely because their cholesterol behaves in a way that’s inflammatory,” she says.
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