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Know your cholesterol numbers


Kenneth Bescak, M.D.

Measuring Cholesterol Levels

According to the American Heart Association, Coronary Artery Disease (CAD) is the No. 1 killer in the U.S. Although the death rate over the last 20 years has decreased, the prevalence has increased. A major risk factor for developing CAD is unhealthy lipid levels, more commonly known as cholesterol, in the blood.

Hyperlipidemia is the general term applied to high blood cholesterol and/or elevated blood triglycerides.

Good and Bad Cholesterol

There are two major types of lipids/cholesterol:

• LDL or low density (especially small particle) lipoproteins, commonly referred to as “bad” cholesterol
• HDL or high density (larger particle) lipoproteins, commonly referred to as “good” cholesterol

Decreasing LDL levels and increasing HDL levels are the primary targets for lipid management in the treatment of CAD. Although some people have a genetic predisposition for high triglycerides and low HDL, most unhealthy levels are due to poor lifestyle choices including lack of exercise, high calorie diets and excess consumption of saturated fats and refined sugars. Because of these choices, over the last 20 years there has been an epidemic in obesity, hypertension, diabetes and pre-diabetes, and the numbers are expected to double over the next 20 years.

Monitoring HDL and LDL Levels

Normal levels are not represented by a single number; rather, they should ideally fall somewhere in a range of normal values. These ranges change with age. For instance, a 25 year old with an LDL of 160 mg/dL is vastly different from a healthy 75 year old with an LDL above 160 mg/dL. The 25 year old would be at risk for cardiovascular disease, especially if a genetic predisposition exists.

Guidelines published by both the American Heart Association and the National Cholesterol Education Program specify these measures (mg/dL):

Total Cholesterol Level  
Desirable: less than 200
Borderline high: 200 to 239
High: greater than 240
 
LDL Cholesterol Level
Optimal: less than 100
Near/above optimal: 100 to 129
Borderline high: 130 to 159
High: 160 to 189
Very high: greater than 190
 
HDL Cholesterol Level 
Men – Low: less than 40
Women – Low: less than 50
High: greater than 60
Ideal: less than 100

Triglyceride Levels
Normal: 100 to 150
Borderline high: 150 to 200
High: 200 to 500
Very high: 500 to 1000
Extreme: greater than 1000
 

Treatment Options

The general recommendation is that people over the age of 20 should have their cholesterol measured once every five years. The best method of measuring cholesterol levels is with a blood test called a lipid panel or lipid profile. Because cholesterol and triglyceride levels rise after a meal – particularly one high in fat, sugars or alcohol – patients may be asked to fast 12 to 14 hours prior to having blood drawn.

When considering treatment options, all these numbers must be considered. Diet has little effect on total the LDL levels. On the other hand, triglycerides are diet and exercise sensitive. Diets low in saturated fats and refined sugars and high in Omega 3 fish oil can lower triglycerides. Additionally, exercise needs to be aerobic for at least one hour each day at least five days per week; red wine in moderation by some persons also can be effective in raising HDL levels.
 
Kenneth Bescak, M.D., diagnostic cardiologist, is a physician at the Heart & Vascular Center of Northern Arizona. Dr. Bescak specializes in lipid management, widely considered the leading indicator of heart disease.



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