Cholesterol Levels - What's Good, What's Bad

It seems that in recent times, as we all are or should be becoming more heart-aware, we are mightily concerned by our cholesterol levels. Rightly so, as high cholesterol levels can lead to hardening of the arteries and ultimately heart attack or stroke.

If you are concerned about your cardiac health, or your cholesterol levels, it is very easy to have it checked by a Doctor, Nurse or Pharmacist. A cholesterol measurement is obtained via a blood test. The standard test for accurate cholesterol measurement is called a lipid profile. It is performed after a 9 to 12 hours without food, because cholesterol levels rise immediately after eating. Such a measurement is a reliable indicator of plaque formation. In this context, plaque is a sludgy substance material that builds up inside the arteries, potentially blocking them.

Importantly, there are two major ways of measuring cholesterol, in millimoles per liter (the British way) or in milligrams per deciliter (favored in the US). Both of these measure total cholesterol in the blood.

In the USA your results (in mg/dL) are likely to be expressed to you in this way:

Ideal (healthy) cholesterol: 200mg/dL or less.
Borderline high cholesterol: 200 - 239 mg/dL
High cholesterol: 240 mg/dL or more.

In the UK, the measurements would be put to you like this:

Ideal (healthy) cholesterol Less than 5 mmol/l
Mildly high cholesterol 5 - 6.4 mmol/l
Moderately high cholesterol 6.5 - 7.8 mmol/l
Very high cholesterol Over 7.8 mmol/l

The issue is further complicated by the fact that LDL cholesterol (the bad guy) and HDL cholesterol (the good guy) are also measured, along with triglycerides. The combination of all three makes up the total cholesterol measurement as above. Despite the total measurement, if the ratio of HDL (good) cholesterol was relatively high, a person would probably have a lesser risk of heart disease than if the reverse were true. It is common to have a higher reading of LDL than HDL, but the worst reading would be a very high overall cholesterol consisting of very low HDL and very high LDL.

A high cholesterol level is not necessarily an automatic indicator you will have a heart attack or a stroke. It is one undesirable factor which is taken into account along with others to assess your risk of heart disease. The worst case scenario would be a heavily obese person who smokes cigarettes, does no exercise, eats fatty foods and no fruit and veg. He also drinks a lot and has a high cholesterol level which runs in his family.

Taken in isolation a high cholesterol level is not necessarily something to panic about. If found in a person who is slim, non-smoking, walks a lot and lives on fruit and veg, chances are it will be genetic in cause. In these cases lifestyle changes are often no good as they cannot fight the familial tendency to the condition. In these cases Statins (cholesterol-lowering drugs) are commonly used.

Most of us fall between the two extremes mentioned above. We can all benefit from having our cholesterol levels checked, as forewarned is forearmed against the insidious onset of heart disease. The majority of people can and should make lifestyle choices to reduce cholesterol levels and other cardiac risk factors.