HDL, LDL? Understanding Your Cholesterol Numbers

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Good cholesterol, bad cholesterol, HDL, LDL. Which number should be high; which should be low? It can be confusing.

Here’s what you need to know about the relationship between cholesterol and heart disease, and how you can reduce your risk.

HDL and LDL: What Do They Mean?

LDL (low-density lipoprotein) is one of two lipoproteins that carry cholesterol in your blood. LDL is known as “bad cholesterol” since it can build up dangerously on the walls of your arteries. Lower LDL is desirable.

On the other hand, HDL (high-density lipoprotein) is called the “good cholesterol” because it actually cleanses your blood of excess cholesterol. Higher HDL is desirable.

Cholesterol is a waxy substance your body needs to stabilize your body’s cells. The value of HDL is that it:

  • Removes LDL cholesterol and takes it back to the liver where it’s reprocessed.
  • Helps keep the inner walls (endothelium) of your blood vessels clean. Damage to these walls is the first step to coronary artery disease.

American College of Cardiology Guidelines

The American College of Cardiology offers the following guidelines to assess cholesterol levels. Values are in mg/dL (milligrams per deciliter) and based on a fasting measurement.

Less than 200
(but the lower 
the better)
Ideal is 60
or higher;
40 or higher
for men and
50 or higher
for women
is acceptable
Less than 100;
below 70 if
artery disease
is present
Less than 149;
ideal is <100
Borderline to
240 or higher
160 or higher;
190 considered
very high
200 or higher;
500 considered
very high
Less than 40

Maintain a Healthy Lifestyle

A heart-healthy lifestyle is at the core of treating high cholesterol and lowering your risk for cardiovascular disease.

  • Eat a diet low in saturated fats, trans fat, and sodium.
  • Make sure you diet includes fruits, vegetables, whole grains, low-fat dairy, poultry, fish, legumes, nontropical vegetable oils, and nuts.
  • Limit sweets, sugar-sweetened beverages, and red meats.
  • Get regular aerobic exercise – 30 to 60 minutes on most days.
  • Maintain healthy body weight.
  • Don’t smoke.
  • Control elevated blood pressure and diabetes.

Talk to Your Doctor About Statin Therapy

Recommendations for drug therapy focus treatment on those adults who are most likely to obtain the greatest benefit. The decision to take statins (Lipitor, Zocor, Crestor) should come after careful discussion with your doctor who understands your personal medical history and can help you weigh the risks and benefits. Generally, statins are recommended if you:

  • Have cardiovascular disease or are at high risk for heart disease.
  • Have an LDL level > 189.
  • Have diabetes and an LDL level between 70 -- 189.

For everyone else, the guidelines say, statins should be considered if the risk of a heart attack or stroke in the next 10 years is at least 7.5 percent. A new risk calculator will help you and your doctor figure that out, using factors such as blood pressure, age, and total cholesterol levels.

author name

Hyasmine M. Charles, MD

Hyasmine M. Charles, MD, is a physician with Lancaster General Health Physicians Women’s Internal Medicine.

Education: A graduate of the Penn State University College of Medicine and the residency program at the University of Rochester, Dr. Charles completed her fellowship at the University of Pittsburgh. She is board certified in internal medicine.

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About LG Health Hub

The LG Health Hub features breaking medical news and straightforward advice to help individuals of all ages make healthy choices and reach their wellness goals. The blog puts articles by trusted Lancaster General Health clinical experts, good 'n healthy recipes, videos, patient stories, and health risk assessments at your fingertips.


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