HDL. LDL. “Good.” “Bad.” If you find cholesterol confusing, you’re not alone.

September 27, 2011

Patient visiting a doctor

How's your cholesterol? National Cholesterol Education Month is a good time to find out.

On its National Cholesterol Education Month web page the National Institutes of Health says that more than 65 million Americans have high blood cholesterol. This is a serious illness. In fact, high blood cholesterol is the major cause of heart disease. So keeping your cholesterol in check means less risk of heart disease, or a heart attack. The NIH page is worth a visit. It offers a range of tips, and even recipes to help people with high cholesterol eat better.

But for now, let's talk about what cholesterol is and what this term "cholesterol levels" means.

What is cholesterol?

The National Heart, Lung and Blood Institute calls cholesterol a "waxy, fat-like substance" that's in every cell of the human body. Cholesterol helps our bodies make hormones and Vitamin D. It also helps us digest food. Our bodies make all the cholesterol we need. But cholesterol is also in some of the food we eat, so we may end up taking in more cholesterol than we need.

Cholesterol travels through our bloodstream in fat and protein "envelopes" called lipoproteins. There are two kinds of lipoproteins: low-density lipoproteins and high-density lipoproteins. You need both kinds of lipoproteins, in healthy levels. But as with everything, there are limits.

The good, the bad, the ugly: the different kinds of cholesterol and what they mean.

Cholesterol that's packaged in low-density lipoproteins is known as "LDL cholesterol." If you've heard of "bad" cholesterol, this is what's being talked about. A high LDL level leads to a buildup of cholesterol in your arteries. (Arteries are blood vessels that carry blood from your heart to your body.)

Cholesterol that travels through your body in high-density lipoprotein "envelopes" is called HDL cholesterol. It's called "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. From there, your liver removes the cholesterol your body doesn't need.

If a blood test shows a high level of LDL cholesterol, doctors say you have a greater chance of heart disease. But if your HDL cholesterol is high, your chances of heart disease are lower.

So when you get your cholesterol tested, remember that too much LDL cholesterol is bad news, while HDL cholesterol is the "good guy."

What is "high blood cholesterol"?

Unfortunately, a lot of people don't know they have high cholesterol, because it doesn't really have any When a blood test shows you have too much cholesterol, you're said to have high blood cholesterol. symptoms.

This is why regular blood tests are so important. Too many people who don't get tested find out they have high blood cholesterol after they have a heart attack or doctors tell them they have heart disease.

The link between cholesterol and heart disease.

It's complex, and there's a lot of chemistry to it. But basically, high blood cholesterol is a big cause of plaque buildup in the arteries.

Plaque is a hard material that's made up of cholesterol, fat, calcium, and other material. Over time, plaque can build up in the arteries. If the plaque builds up enough, it can block an artery. And when blood can't carry oxygen to the heart, chest pain or a heart attack often follow.

If a piece of the built-up plaque breaks free, it can travel to other parts of the body. When this happens, it can cause a stroke. Another cause of stroke is when plaque builds up in and blocks the arteries that bring blood to your brain. Or plaque can build up in still other arteries – the ones that carry blood and oxygen to your arms or legs – and cause a problem called "peripheral artery disease" (PAD).

So plaque is, all in all, very bad news. And high blood cholesterol is a big reason for plaque.

We hope this helps you see why it's so important to keep your blood cholesterol within normal levels. Lowering your blood cholesterol may slow down, reduce, or even stop the buildup of plaque in your arteries. It may also reduce the risk of plaque breaking up and leading to dangerous blood clots.

Below 200 mg/dL is good.

The Centers for Disease Control and Prevention says that total cholesterol levels below 200 mg/dL are the goal. Levels at or above 200 mg/dL are unhealthy. Levels of 240 mg/dL or higher put people at high risk for heart disease.

The CDC says that more than 35 million Americans have total cholesterol levels above 240 mg/DL. Simply put, these people are in trouble. We hope you're not one of them.

You can control your cholesterol.

We live in good times. Today, there are all kinds of ways to control high blood cholesterol. If your levels aren't too high, you might just need to eat healthier. Or, your doctor may decide you need medicine. If that's the case, there are many drugs on the market that can help. And every day, science moves closer to making cholesterol control easier.

A MedicineNet article lists the things that contribute to high or low LDL cholesterol. The major ones are:

  • Heredity
  • What you eat
  • Weight
  • Physical activity/exercise
  • Age and gender
  • Alcohol
  • Stress

As we said before, your body already makes all the cholesterol you need. However, cholesterol is found in many foods we eat. So lowering your blood cholesterol begins with lowering the cholesterol you take in.

Saturated fat is most often found in meat or other foods made from animals. It's one of the things that raises LDL ("bad") cholesterol. The other main LDL booster is just plain cholesterol, which only comes from animal products. Of the two, saturated fat takes the prize for raising LDL cholesterol the most. So if you cut your saturated fat and cholesterol, you're taking a major step toward dropping your blood cholesterol levels.

Low fat and high-fiber foods are the best dietary choices for fighting high cholesterol. What kinds of foods would these be? Fresh fruits, fresh vegetables, and whole grains, of course!

The National Heart Lung and Blood Institute (part of the U.S. Department of Health & Human Services) has created a great website of foods and recipes for a cholesterol-reducing diet. You might be surprised at how tasty eating healthy can be.

Testing your cholesterol is simple.

A five-minute trip to the doctor's office and a small blood sample are all you need to get a full picture of your cholesterol levels. The National Cholesterol Education Program says you should have your cholesterol tested every five years after age 20.

What's more, there's a growing belief that children and teens should have their cholesterol checked, too. New studies show that more than 20% of children aged 12 to 19 have at least one lipid (cholesterol) level that's out of normal range. So if you have kids, you may want to ask your doctor about testing them: especially if they're overweight, "underexercised," or your family has a history of early heart disease.

So get started. Call your doctor today about a cholesterol blood test.

This National Cholesterol Awareness Month could have the day that makes all the difference in your life!

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