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Elevated Cholesterol 2: What is high cholesterol and what levels of LDL and HDL are considered healthy?

How is high cholesterol defined?

A total blood cholesterol level greater than 200 mg/dL, but less than 240 mg/dl, is considered by the American Heart Association (AHA)to be a moderately elevated cholesterol level. The AHA also considers this level to pose a borderline high risk to your health. Changes in diet and lifestyle are recommended for anyone with a total cholesterol level that falls into this range. A total blood cholesterol level greater than 240 mg/dL is considered to be high risk. This level carries with it a greater risk of heart attack, stroke, and coronary heart disease. If you total cholesterol falls into this upper range, you'll want to consult with your healthcare practitioner about the possibility of further lab tests or medications that can lower your total cholesterol level. Diet and lifestyle changes will still be extremely important if your cholesterol level falls into this upper range. However, these changes alone may or may not be enough to bring your cholesterol level back into a range that is agreed upon by you and your healthcare provider.

What are LDL and HDL?

Total cholesterol is not the only way - and not necessarily the best way - to evaluate your cholesterol status. Blood cholesterol can be broken down ("fractionated") into several types. These cholesterol types involve the various protein-containing molecules that transport cholesterol around the body. LDL (low-density lipoprotein) and HDL (high-density lipoprotein) are two of the best-studied transport molecules. LDL tends to carry cholesterol outward from the liver to the rest of the body tissue. This LDL cholesterol transporter is not capable of picking up cholesterol at various points around the body and bringing it back to the liver. The HDL transporter molecule is needed to carry out this "reverse" transport of cholesterol from tissue sites throughout the body back to the liver. Since this reverse transport of cholesterol back to the liver can help remove cholesterol from the bloodstream (and eventually from the body), HDL is considered a heart-protective transport molecule. Increasing your HDL level is most often a very helpful step in protecting the health of your heart.

How low should my LDL be?

The American Heart Association (AHA)recommends an LDL level of 100mg/dL or below as ideal. 130mg/dL is considered borderline high. Any LDL reading of 190mg/dL or above is considered very high.

How high should my HDL be?

An HDL level of 40-50mg/dL is considered average for an adult male according to the American Heart Association (AHA). For adult women, the corresponding range is 50-60 mg/dL. If your HDL is below 40 mg/dL, that level would definitely be considered too low by the AHA.

What's a good LDL:HDL ratio?

It lowers your risk of heart problems to keep your LDL:HDL ratio on the low side. A ratio at or below 3:1 (no more than three times as much LDL as HDL) is almost always recommended. It takes a ratio of 2.3:1 or below to put you significantly below average risk. It's also important not to confuse LDL:HDL ratio with total cholesterol:HDL ratio. This second type of ratio is also commonly used in cholesterol assessment. In the case of total cholesterol:HDL, a common goal is always to stay below 5:1. But a total cholesterol:HDL ratio of 4:1 would be even better, and a ratio of 3.5:1 is described as optimal by the American Heart Association.

For more information on cholesterol see: