Your doctor can diagnose high cholesterol with a simple blood test called a fasting lipid or lipoprotein profile.

There are four numbers that you and your doctor should be concerned about when determining whether or not you have high cholesterol.

Total Blood or Serum Cholesterol

This is the sum of your HDL and LDL cholesterol scores and is generally a good indicator of whether you’re at risk for heart disease.

  • Optimal: Less than 200 mg/dL
  • Borderline high: 200-239 mg/dL
  • High: 240 mg/dL or higher

High-Density Lipoprotein (HDL)

High-Density Lipoprotein (HDL) is considered the “good” cholesterol because it helps keep the arteries clear of the clogging “bad” LDL cholesterol. In most people, high HDL helps protect against heart disease. Low levels of HDL are associated with a greater risk of heart disease. Therefore, the higher your HDL score is, the better. If your HDL falls in the “low” range, you are considered a major risk for heart disease.

  • Low: less than 40 mg/dL for men and less than 50 mg/dL for women
  • Normal: above 45 mg/dL for men and above 55 mg/dL for women
  • Optimal: 60 mg/dL and above can lower your risk of heart disease

Low-Density Lipoprotein (LDL)

A high level of “bad” LDL cholesterol can clog the arteries and is a major risk factor for heart disease. Keeping your LDL as low as possible is a good way to protect your health.

  • Optimal: Less than 100 mg/dL
  • Normal/Near Optimal: 100-129 mg/dL
  • Borderline High: 130-159 mg/dL
  • High: 160-189 mg/dL
  • Very High: 190 mg/dL and above

People with heart disease and those who are at very high risk of heart disease (such as those with metabolic syndrome) need to keep their LDL even lower than the optimal score (less than 70 mg/dL is recommended).

People with diabetes or multiple risk factors for heart disease (such as smoking or having low HDL levels) should aim for an LDL reading within the optimal category.

It is important to consult your physician about where your ideal LDL levels should be.

Triglycerides

Triglycerides are another type of fat found in the bloodstream. A high level of triglycerides is associated with a greater risk of heart disease. When it comes to your test results, the lower the number, the better.

  • Normal: less than 150 mg/dL
  • Borderline High: 150-199 mg/dL
  • High: 200-499 mg/dL
  • Very High: 500 mg/dL and above
Read Video Transcript »

Doctor’s Whiteboard: “High Cholesterol 101”

Cholesterol, and its role in the body, is one of the most misunderstood topics in the world of healthcare. You’ve likely read or watched numerous news reports about the dangers of cholesterol in your diet and how it can lead to heart disease. But that’s far from the whole story.

Cholesterol is a crucial building block of every cell in your body. It’s so important that your liver actually produces most of the cholesterol that you’ll ever need, regardless of your diet.

There are two main types of cholesterol. LDL, or low-density, cholesterol particles are a combination of fat and protein that travel through your bloodstream and deliver cholesterol to the tissues that need it, such as nerve cells. HDL, or high-density, cholesterol particles contain a much higher ratio of protein to fat, and their function is to scour the bloodstream, vacuuming up excess bits of cholesterol and returning those to the liver. HDL also helps keep the blood vessels and arteries clear, and that’s why it’s often referred to as “good” cholesterol.

Cholesterol can become dangerous when your body has too much LDL or “bad” cholesterol. These fatty particles can accumulate inside of blood vessels and form clogs, or plaques, which can lead to a heart attack.

For many people, it’s possible to control cholesterol levels by making changes to their diet, like avoiding saturated fats, and getting more exercise. However, since the liver produces roughly 75 percent of a person’s total cholesterol, lifestyle changes are not always effective. 

One of the key medications to treat high cholesterol is a class of drugs called statins. Statins work to block the production of cholesterol in the liver and have been shown to bring down LDL levels, boost HDL levels, and lower the risk of developing heart disease.

Statins, like any medication, have side effects and may interact with treatments for related conditions. People who are taking other medications, such as blood thinners, may be at risk for developing drug interaction side effects. Many medications are metabolized, or broken down, in the liver. For some people with elevated cholesterol, it sometimes makes sense to use a statin that breaks down outside of the liver where there is less of a chance for dangerous side effects.

The good news about cholesterol is that through a combination of diet, exercise, and working with your doctor, it’s possible to dramatically reduce your risk of heart disease. If you’d like to learn more about treating high cholesterol, take a look at the information we have here at Healthline or make an appointment with your doctor.