Many people are not aware they have atherosclerosis until they have a heart attack or stroke.  People can have up to 80% closure of their arteries without experiencing any symptoms. This is unfortunate and makes cholesterol somewhat of a hidden danger.

In the United States it is unusual to find an adult without some degree of atherosclerosis. Most people start to develop cholesterol buildups that precipitate atherosclerosis when they are children.

A simple blood test is needed to diagnose cholesterol levels. The blood levels of LDL and HDL are vital information.  The tests for cholesterol need to be done after a period of “fasting” or the results are not accurate.  Simple screening without “fasting” measures only the total cholesterol and HDL (the “good” cholesterol).   It provides only a partial picture of the situation.  The complete test, a “lipid profile”, can vary from test to test but it measures total cholesterol, HDL, LDL and triglycerides.

To obtain accurate readings, the fasting involves not eating or drinking anything except water for 12 hours before testing.  Avoid vigorous exercise for 24 hours before testing. Be certain to tell the technician about any medications you may be taking because they might affect the results.

Once you have accurate numbers, what do they mean?   A little clarification is needed before we discuss the numbers and their meanings.

Dietary cholesterol is the cholesterol that you eat.  The American Heart Association recommends an intake of 300 milligrams or less per day.  Cholesterol is included on most food labels in the United States.

Three terms, blood cholesterol, serum cholesterol and total cholesterol refer to the total cholesterol in your body. That is what they measure from your blood sample. 

Your test results should have three numbers:
1. HDL Cholesterol
2. LDL Cholesterol
3. Total Cholesterol
National Cholesterol Education Program recommends total cholesterol levels below 200 milligrams/dl (milligrams per deciliter).This is currently considered “desirable.” A reading between 200 and 239 is “borderline high.” Any reading beyond 240 is “high.”

Triglyceride levels over 400 milligrams/dl are considered “high”. Triglyceride levels over 1,000 milligrams/dl are considered “very high.”

The desirable level for LDL is less than 130 milligrams/dl.  “Borderline high” readings are from 130 to 159.  The “high risk” level is 160 and above for LDL.

You want higher HDL levels. The numbers are lower for HDL because overall there is less HDL in the blood. Anything lower than 35 milligrams/dl is considered “high risk.”  If your HDL is very high or over 60, your risk of heart disease is reduced.

LDL is the “bad” cholesterol and the most important factor in predicting heart attack.  For LDL it is better to be lower than 160.      For your optimal health you should try not to exceed 130.

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