Judy Foreman

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If your cholesterol and HDL are really good, do you need to worry about your LDL?

October 12, 2004 by

Probably not, but it depends.When doctors do a cholesterol blood test, they’re looking for your low-density lipoprotein, or LDL, cholesterol; your high-density lipoprotein, or HDL; and your triglycerides, or fatty acids in the blood. LDL is considered the “bad” cholesterol because is gets deposited in blood vessel walls as plaque; HDL is “good” because it take cholesterol out of the blood.

Your total cholesterol score is the sum of LDL, HDL and very low-density lipoprotein, or VLDL, which is computed by taking your triglycerides and dividing by 5.

In people without heart disease and at low or ordinary risk for it, total cholesterol should be 200 milligrams per deciliter or less, according to guidelines issued by cholesterol experts several years ago. LDL should be 130 or less. In those with heart disease or at very high risk, LDL should be less than 100 and, “better still, under 70,” said Dr. Daniel Levy, director of the National Heart Lung and Blood Institute Framingham Heart Study. HDL should be above 40. Triglycerides should be 150 or lower.

So, if your total cholesterol were, say, 208 and your HDL were 100, by mathematics alone, that suggests your LDL is admirably low, said Dr. Zoran Nedeljkovic, an interventional cardiologist at Boston Medical Center.

Still, to assess your overall risk of heart disease, doctors also need to know your age, sex, smoking history, blood pressure, family history of heart disease, whether you have diabetes, and how much you exercise. In general, if either your total cholesterol or your LDL is higher than desirable, you can try losing weight and controlling fat intake. If that doesn’t work well enough, doctors often prescribe statin drugs.

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