Cholesterol: Playing the Numbers Game

Let’s be honest: Keeping track of your heart health means that you’re going to have to focus on a lot of numbers—and cholesterol levels are a great place to start.

4 Keys to Cholesterol

When you hear the word cholesterol, a lot of different ideas may pop into your head. Some people love to obsess about their total cholesterol number, while others take comfort in having a healthy good cholesterol score. The reality is that most doctors today consider four numbers when monitoring cholesterol.

The four key blood lipid numbers are:

1) Total cholesterol
2) Low-density lipoprotein (LDL)
3) High-density lipoprotein (HDL)
4) Triglycerides (Trigs)

Cholesterol itself is not bad. In fact, your body actually needs this waxy substance to create cell membranes and hormones, and to protect nerves. Too much cholesterol, however, is a major risk factor for heart disease.

Familiarize yourself with the following terms:

LDL: This is the so-called bad cholesterol. (Remember that “L” stands for “low,” and you want this lipid level to be a low number.) LDL shuttles cholesterol through the bloodstream from the liver to the rest of the cells in the body.

HDL: This is the good cholesterol. (The “H” stands for “high.” The higher this lipid number, generally speaking, the better your heart health.) HDL drives unused cholesterol from the cells back to the liver, where it’s excreted. Any “leftovers” that the HDL can’t handle stay in the body and may start collecting in the blood vessels. So, the higher your HDL level is, the more excess cholesterol will get disposed of by the liver—leaving less cholesterol to wreak havoc in your body.

Triglycerides (Trigs): These are fats that provide your body with energy—and that’s a good thing. But just like cholesterol, any Trigs that are not used for energy remain in the blood. When that happens, Trig levels can jump and then contribute to—and even speed up—hardening of the arteries.

Is Your Cholesterol Too High?

To diagnose high cholesterol, your doctor will likely perform a fasting cholesterol test—called a “fasting lipoprotein profile.” The test typically requires you not to eat or drink anything but water for 9-12 hours before having blood drawn.

Everyone over 20 should get this test every five years. (If you’re over 20 and haven’t gotten one yet, do it now!) If you are 50 or older, or if you have specific risk factors, get tested yearly or as often as your doctor recommends. If you already take medications to treat high cholesterol, your doctor may recommend more frequent blood tests to be sure the medication is doing its job.

When monitoring your blood lipids, you’ll need to focus on all four key numbers (total cholesterol, LDL, HDL and triglycerides). Keep in mind that your numbers may vary slightly depending on factors like your overall health and family history. Talk to your doctor about the results of any tests you get.

Cholesterol Numbers That Matter

Total Cholesterol Level
Less than 200 Optimal
200 – 239 Borderline high
240 and higher High
LDL(bad) Cholesterol Level
Less than 100 Optimal
100 – 129 Near or above optimal
130 – 159 Borderline high
160 – 189 High
190 and higher Very high
HDL(good) Cholesterol Level
60 and higher Optimal
Less than 50 Low for women
Less than 40 Low for men
Trigs Level  
Less than 150 Optimal
150 – 199 Borderline high
200 – 499 High
500 and higher Very high


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