Expert Nutrition

How to Understand Cholesterol Test Results

This article can help you to understand your cholesterol test results. You will benefit most from this article if you have a copy of your results handy such that they can be explained below.

When testing for cholesterol your treating health professional will usually order a complete lipid profile which examines the fat (lipid) chemistry of your blood. Results are used to gage your risk for heart disease and to develop a treatment plan. Although having your cholesterol levels tested is a common medical practice, very few people understand their cholesterol test results.

It's a good idea to keep a record of your cholesterol test results, many doctors will only tell you if your cholesterol levels are high or low and not provide you with the actual data. You should always request a copy of the actual numbers so that you know exactly how you’re travelling and what areas you need to work on or need to watch in future. Keeping a record of your results can help you to detect any problems early and also allows you to monitor the impact your lifestyle.

When should I have my cholesterol tested?

After the age of 19 you should get your cholesterol checked at least every five years. Naturally if you have experienced any high readings, have a family history of high cholesterol, you are getting older or you feel that your health has recently deteriorated (eg you’ve gained a lot of weight) then it is a good idea to be tested more regularly. It should be noted that cholesterol test results can vary up to 10% within one month and therefore it is worth being tested again after 3 months if you have a high reading.

What Cholesterol Test Results Should I Understand?

A lipid profile normally includes the following test results which are explained in more detail below:

  • Total Cholesterol (TC)
  • Low Density Lipoprotein cholesterol (LDL), commonly referred to as “Bad Cholesterol”
  • High Density Lipoprotein cholesterol (HDL), commonly referred to as “Good Cholesterol”
  • Triglycerides (TG)
  • HDL/LDL ratio
Not all cholesterol is bad, so let’s review each of these tests so you can gain a better understanding of your results.

Total Cholesterol (TC)

Total Cholesterol includes both the good (HDL) and bad (LDL) cholesterol levels combined. This test gives you an overall estimate of your cholesterol results, however should not be the only result used to assess your level of risk. The ratio of good to bad cholesterol as well as your triglyceride levels should also be considered.

Metric (mmol/L) Imperial (mg/dl) Analysis
< 5.0 < 200 Low Risk
5.0 – 5.5 200 – 240 Borderline
> 5.5 > 240 High Risk

LDL - "Bad Cholesterol"

LDL (Low Density Lipoproteins) is the “bad cholesterol” as it deposits cholesterol in your artery walls leading to inflammation blockages and potential blood clots. A high LDL cholesterol test result indicates that you are at greater risk of developing cardiovascular disease. This should be of concern to you and your goal should be to maintain a healthy LDL level to reduce your risk of having a heart attack or stroke.

Metric (mmol/L) Imperial (mg/dl) Analysis
< 2.6 < 100 Low Risk
2.6 – 3.3 100 - 129 Moderate Risk
3.3 - 4.1 130 - 159 Borderline High Risk
4.1 - 4.9 160 - 189 High Risk
> 4.9 > 190 Very High Risk

HDL - "Good Cholesterol"

HDL (High Density Lipoproteins) is the “good cholesterol”. HDL transports bad cholesterol out of the artery walls back to the liver so that it can be processed. Raising your HDL will reduce your risk of cardiovascular disease. When it comes to HDL cholesterol the bigger then number the better the result. A low score puts you at greater risk.

Metric (mmol/L) Imperial (mg/dl) Analysis
< 1.03 < 40 High Risk
1.03 - 1.54 40 – 59 Moderate Risk
> 1.55 > 60 Low Risk

Triglycerides (TG)

Triglycerides are the chemical form of fat in your blood stream derived from foods eaten, and other sources of energy in the body such as carbohydrates. High levels may lead to blocked arteries. High levels of triglycerides are associated with a greater risk of heart attacks and strokes.

Metric (mmol/L) Imperial (mg/dl) Analysis
< 1.70 < 150 Low Risk
1.70 – 2.25 150 - 199 Borderline High Risk
2.26 – 5.65 200 - 499 High Risk
> 5.65 > 500 Very High Risk

LDL : HDL Ratio

This calculation provides a more accurate representation of an individual’s risk of cardiovascular disease as it compares the amount of bad cholesterol to the amount of good cholesterol. It is not uncommon for this ratio to be left out of your test results however it can be easily calculated by dividing the LDL cholesterol result by the result you got for your HDL cholesterol (ie LDL/HDL).

Men Women Analysis
< 3.4 < 3.3 Optimal
4.0 3.8 Low Risk
5.0 4.5 Moderate Risk
9.5 7.0 High Risk
> 23 > 11 Very High Risk

Are there any other blood tests I should have?

Whilst having your cholesterol checked is the most common blood test used to measure your risk of cardiovascular disease, recent studies suggest that there are additional tests that can be done that may also indicate a greater risk of cardiovascular events (such as heart attack or stroke).

The InterHeart study one of the largest studies published in recent times suggests that measuring APOA/APOB could be useful test for predicting heart attacks. Other studies have indicated that measuring inflammatory markers such as high sensitive CRP have also be shown to help predict cardiovascular disease in individuals who otherwise have normal cholesterol results.

These studies are still relatively new and need further investigation before any recommendations can be set, in the mean time if you have any concern you may wish to discuss these with your doctor.

Now that you understand your cholesterol test results let’s look at how to improve them...

Cholesterol Lowering Program

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