Understanding the Different Levels of Cholesterol
- Total cholesterol
- Low density lipoprotein (LDL) -- the "bad" cholesterol
- High density lipoprotein (HDL) -- the "good" cholesterol
- Triglycerides.
The level of total cholesterol (as the name implies) refers to the total amount of cholesterol in the bloodstream. Total cholesterol combines levels for HDL, LDL, and another type of cholesterol known as VLDL, or very low density lipoprotein.
A total cholesterol reading over 240 mg/dL is high, a level between 200 and 239 mg/dL is borderline high, and anything under 200 is a healthy cholesterol level. If your total cholesterol is higher than 240 mg/dL, your risk for heart disease and stroke is higher.
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Total Cholesterol Level
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Total Cholesterol Category
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Less than 200 mg/dL
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Desirable
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200-239 mg/dL
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Borderline high
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240 mg/dL and above
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High
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(Cholesterol levels are measured in milligrams [mg] of cholesterol per deciliter [dL] of blood.)
Total cholesterol can be misleading, though, because a person can have a healthy total cholesterol and still have either a low HDL level or a high LDL level. Therefore, most cholesterol treatment decisions are based on HDL and LDL cholesterol levels, not total cholesterol. So, it's best to think of the total cholesterol number as an overview number.
High-density lipoprotein ( HDL) is the "good" cholesterol. HDLs carry cholesterol in the blood from other parts of the body back to the liver, which leads to its removal from the body. So HDL helps keep cholesterol from building up in the walls of the arteries. If your HDL cholesterol level is below 40 mg/dL, you are at substantially higher risk for heart disease. The higher your HDL cholesterol level, the better.
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HDL Cholesterol Level
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HDL Cholesterol Category
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Less than 40 mg/dL
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40-59 mg/dL
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The higher, the better
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60 mg/dL and above
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Considered protective against heart disease
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The average level of HDL cholesterol for men is about 45 mg/dL; for women, it is about 55 mg/dL.
Low-density lipoprotein ( LDL) is the "bad" cholesterol. LDLs carry most of the cholesterol in the blood, and the cholesterol from LDL is the main source of damaging buildup and blockage in the arteries. Thus, the more LDL you have in your blood, the greater your risk of heart disease.
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LDL Cholesterol Level
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LDL Cholesterol Category
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Less than 100 mg/dL
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Optimal
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100-129 mg/dL
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Near optimal/above optimal
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130-159 mg/dL
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Borderline high
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160-189 mg/dL
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High
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190 mg/dL and above
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Very high
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This is not the complete story regarding LDL cholesterol. Optimal levels also take into account your risk for heart disease.
The following table outlines recommended LDL cholesterol levels based on your risk category.
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If You Have
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You Are in Category
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And Your LDL Goal Is
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Heart disease, diabetes, or a risk score higher than 20%
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I. Highest risk
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Less than 100 mg/dL
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Two or more risk factors and a risk score 10%-20%
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II. Next highest risk
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Less than 130 mg/dL
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Two or more risk factors and a risk score lower than 10%
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III. Moderate risk
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Less than 130 mg/dL
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One or no risk factors
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IV. Low to moderate risk
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Less than 160 mg/dL
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Triglycerides are not actually cholesterol, but a form of fat carried through the bloodstream. Most of your body's fat is in the form of triglycerides stored in fat tissue. Only a small portion is found in the bloodstream.
High triglyceride levels alone do not necessarily cause atherosclerosis. But some lipoproteins that are rich in triglycerides also contain cholesterol, which causes atherosclerosis in some people with high triglycerides. Also, high triglycerides are often accompanied by other factors, such as low HDL or diabetes, that raise the risk of heart disease. Therefore, high levels may be a sign of a lipoprotein problem that contributes to heart disease.
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Triglyceride Levels
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Triglyceride Category
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Less than 150 mg/dL
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Normal
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150-199 mg/dL
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Borderline high
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200-499 mg/dL
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High
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500 mg/dL or above
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Very high
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Triglyceride levels that are borderline high (150 to 199 mg/dL) or high (200 mg/dL or more) may require treatment.
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD