Getting your cholesterol readings in the right zone can reduce your risk of heart attack, stroke, and more. But what exactly do all those numbers mean anyway?
Blink Health,Jul 29, 2020 • 4 min read
If you’ve recently had a physical, your doctor’s likely talked about the importance of keeping your cholesterol in check. Cholesterol, a fat-like, waxy substance made by your body and absorbed from the food you eat, can cause plaque to build up in your arteries—it’s a major cause of strokes, heart attacks, and other vascular problems.
To keep it in line, first you need to know how much you have. But results from a cholesterol blood test can be confusing, says Roger Blumenthal, MD, director of Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease in Baltimore, MD.
That’s why we created this guide. It’ll help you understand what all the numbers in your score mean and set you on the path toward getting—and keeping—your cholesterol in the right zone.
The results of your blood work will look something like this:
Total cholesterol: This number is the sum of three major components: low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL).
Target number: 200 milligrams per deciliter (mg/dL) or lower
Here’s how to understand each of those individual components:
LDL cholesterol: This is the “bad” cholesterol. LDL particles like to stick to the lining of your blood vessels and arteries, creating inflammation that in turn converts the particles into plaque. Plaque makes veins narrower, restricting blood flow, and possibly leading to heart attacks and strokes.
Target number: 120 milligrams per deciliter (mg/dL) or lower for healthy adults; 70 mg/dL for those at high risk of heart disease
HDL cholesterol: Known as the “good” cholesterol, HDL helps your body get rid of LDL cholesterol. Experts believe HDL particles attach to LDL cholesterol in your blood and carry it back to your liver, where it can be broken down and removed.
Target number: 45 mg/dL or higher for men and 55 mg/dL or higher for women
Triglycerides: VLDL cholesterol is produced in the liver and released into the bloodstream, where it turns into a type of fat called triglycerides that contribute to plaque formation in your veins. Unlike LDL and HDL, there’s no simple way to measure VLDL cholesterol. Instead, it’s estimated as a percentage of your triglyceride levels.
Target number: 150 mg/dL or lower; anything over 200 mg/dL is considered high
Taking Control of Your Cholesterol
Despite the fact that nearly one in three Americans has high cholesterol, most of us aren’t sure what to do about it. There are several lifestyle changes you can make to improve your numbers, says Dr. Blumenthal. These are the biggies:
Eat a healthy diet. Research increasingly shows that following a Mediterranean diet can help lower “bad” LDL cholesterol and raise your “good” HDL levels. “The more fruits, vegetables, whole grains, and fish—and the less refined carbs, sugar, and processed meats—you eat, the lower your long-term risk of developing cardiovascular disease,” says Dr. Blumenthal.
Exercise. Regular physical activity lowers LDL and VLDL cholesterol (i.e. triglycerides) and raises HDL cholesterol. Moderately vigorous exercise has the added bonus of increasing the size of the particles that make up your LDL cholesterol, which makes them less harmful.
Quit smoking. Smoking damages the walls of your blood vessels, making them more prone to accumulating plaque. “People who smoke also tend to have lower levels of protective HDL cholesterol,” adds Dr. Blumenthal.
Take a statin. If you’re struggling to improve your cholesterol numbers through lifestyle changes alone, a prescription statin is a good option. “This well-studied class of medications has been shown to lower LDL cholesterol anywhere from 20 to 55 percent,” he says. If you’re prescribed a statin like simvastatin (generic Zocor), atorvastatin calcium (generic Lipitor), or pravastatin (generic Pravachol), be sure to check Blink Health to see if you can fill your Rx for less and (bonus!) get it delivered to your doorstep for free.