Measuring Cholesterol Levels
According to the American Heart Association, Coronary Artery Disease (CAD) is the number one killer in the United States. 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 1,000
Extreme: greater than 1,000
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 of 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. FBN
Kenneth J. Bescak, M.D., F.A.C.C., diagnostic cardiologist at the Heart & Vascular Center of Northern Arizona, is the only board-certified lipidologist north of Phoenix. He is one of only eight certified lipidologists in Arizona. As a lipidologist, Dr. Bescak focuses on lipid and lipoprotein metabolism and its associated disorders. He specializes in the diagnosis and treatment of cholesterol disorders, which cause atherosclerosis and cardiovascular disease. Approximately one-third of all deaths in the U.S. are attributed to these health concerns.
To schedule an appointment with Dr. Bescak or any of the cardiovascular physicians at the Heart & Vascular Center of Northern Arizona, call 928-773-2150. For more information, visit NAHeartCare.com.
HVCNA is a cardiovascular physician practice offering services including general cardiology; rhythm abnormalities; the treatment of chronic heart and vascular conditions; and advanced surgical procedures including traditional and minimally invasive open heart surgery. HVCNA cardiovascular specialists include cardiologists, interventional cardiologists, an electrophysiologist, cardiothoracic and vascular surgeons, and specialty trained physician assistants, nurse practitioners and registered nurses. HVCNA is a partnership between Flagstaff Medical Center and Verde Valley Medical Center, with offices located in Flagstaff, Camp Verde, Cottonwood, Sedona, Williams and Winslow. For more information, visit NAHeartCare.com. To make an appointment, call 877 928-WELL.