When a patient's cholesterol levels are determined, it is useful to consider the results in terms of the cholesterol ratio as well as the total amount of cholesterol present in the blood. This is because the different components play very different roles in the formation and buildup of cholesterol in the arteries. Knowledge of their concentrations relative to one another and to the total cholesterol present can provide a more accurate indication of a patient's risk of developing heart disease.

What are cholesterol numbers?

Blood cholesterol tests are able to distinguish between and measure the concentrations of three different types of cholesterol in the blood: LDL (low density lipoprotein), HDL (high density lipoprotein), and VLDL (very low density lipoprotein).

The concentration of each of these, measured in milligrams/deciliter, determines the corresponding cholesterol numbers, and the total is equal to the sum of all three. Test results are often given in terms of a total cholesterol number and a cholesterol ratio representing either Total/HDL or LDL/HDL.

Low-density LDL cholesterol, commonly referred to as "bad" cholesterol, is strongly linked to the development of cardiovascular disease. Elevated levels of both LDL and VLDL in the blood can lead to a buildup of plaque along artery walls, causing them over time to narrow and harden (this is called atherosclerosis).

The higher-density HDL cholesterol, on the other hand, is able to pick up excess LDL and VLDL that have accumulated both in the blood and along arterial walls. For this service, we give it the name "good" cholesterol and as such it is one of the cholesterol numbers we'd like to keep as high as possible. With high HDL, your Total/HDL and LDL/HDL cholesterol ratios will be as low as possible, which will significantly lower your risk of developing coronary heart disease.

Maintaining healthy cholesterol levels

In order for patients to better understand their cholesterol profile results and maintain healthy cholesterol levels, doctors have established guidelines for cholesterol numbers.

For total cholesterol, less than 200 mg/dl is optimal, and the total level should be kept below 240 mg/dl to avoid the risk of heart disease. For LDL, less than 100 mg/dl is optimal, and the total level should be kept below 160 mg/dl.

Finally, a healthy HDL cholesterol level is set above 60 mg/dl, and should be kept above 40 mg/dl for men and above 50 mg/dl for women to prevent excessive LDL accumulation in the blood and along the artery walls.

These cholesterol number guidelines can be used to determine healthy cholesterol ratios as well. For example, a patient with total cholesterol number 200, LDL number 100, and HDL number 60 has a Total/HDL cholesterol ratio of 200/60 and an LDL/HDL ratio of 100/60. This gives an optimal Total/HDL ratio of about 3.3:1 and an optimal LDL/HDL ratio of about 1.7:1.

It is important to maintain healthy cholesterol levels to lower your risk of cardiovascular disease. As such, you should have your cholesterol checked regularly to see where you stand. After all, your health depends on it!