Cholesterol: The Good and the Bad

So you've been diagnosed with high cholesterol.  You know that's not good.  But what's all this about "good" and "bad" cholesterol?  How can you get more of the good and less of the bad?  

Cholesterol is a natural waxy substance in our bodies.  In fact, we need cholesterol for digestion and to make Vitamin D and hormones.  Three-quarters of our cholesterol  is churned out by our liver and other cells.  Only one-quarter comes from food we eat.

When doctors check our cholesterol, they're looking at two numbers.  One measures the level of high-density lipoprotein or HDL.  That's the good kind.  The other measures low-density lipoprotein or LDL.  That's the one that gets us into trouble.

As LDL travels through the blood stream, it builds up inside our arteries.  It contributes to the formation of plaque, a thick, hard substance.  When plaque forms, the artery walls become clogged and stiff.  As the American Heart Association explains, this condition is called atherosclerosis.

When atherosclerosis becomes very bad, our arteries are blocked and we are at risk of a heart attack or stroke. 

HDL, on the other hand, is beneficial.  About one-fourth to one-third of cholesterol in our bodies is HDL — the more the better. If you have low levels of HDL, you're at greater risk of heart attack and of heart disease.

Because there are no symptoms of the condition, the only way to find out if you have high cholesterol is with a blood test.  You'll want to know not only the total amount of cholesterol, but how much of each kind — LDL and HDL — you have.  

Cholesterol is measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.  According to the National Heart, Lung and Blood Institute:

• a total cholesterol level of less than 200 mg/dL is desirable
• LDL levels of 130-159 mg/dL are borderline high
• LDL levels of 190 mg/dL and above are very high
• HDL levels of less than 40 mg/dL are bad and a major risk for heart disease
• HDL levels of 60 mg/dL or more are very good and protect against heart disease 

Fortunately there are effective ways to lower the bad LDL cholesterol and raise the good HDL.  A combination of diet, exercise and, if necessary, medication can help. Your doctor can advise you how best to manage your high cholesterol.