Total Cholesterol and Heart Disease: Reducing Your Risk

guidelines for targeted cholesterol and triglyceride levels continue to move lower

By Roberta H. Anding, MS, Baylor College of Medicine and Texas Children’s Hospital
Edited by Kate Findley and proofread by Angela Shoemaker, Wondrium Daily

Knowing your blood cholesterol is one step you can take to mitigate your risk for heart disease. What should these numbers be, though? Professor Anding explains how the guidelines have changed in recent years and what this means for you.

Man getting his blood pressure checked
Controlling your cholesterol and triglyceride levels can help you to lower your risk of developing heart disease. Photo By wutzkohphoto / Shutterstock

Deciphering Test Results

Heart disease comes in several forms including thrombotic strokes, hemorrhagic strokes, and congestive heart failure. Although non-modifiable factors such as genetics and aging can contribute to heart disease, we can still take actions like following a consistent exercise plan, eating healthy, and getting tests done that will determine total cholesterol and other contributors of heart disease.

This article series delves deeper into how to live a heart-healthy lifestyle, including your diet and tests your physician can perform that help you to better understand and mitigate your personal risk. Once you receive blood work results from your physician, though, it can be difficult to determine the significance of these results.

Let’s determine, first and foremost, what your blood cholesterol and blood level of triglycerides should be. Most public health recommendations now advise that total blood cholesterol should be less than 200 milligrams per deciliter or lower. 

What Is Total Cholesterol?

Some research suggests that your risk of heart disease starts to climb when your total cholesterol is about 150 milligrams per deciliter. These are adult values. According to the American Academy of Pediatrics, for adolescents and children, the value should be less than 170 milligrams per deciliter, according to the American Academy of Pediatrics.

“‘Total cholesterol’ is an umbrella term,” Professor Anding said. “It has lots and lots of spokes underneath it. It’s made up of subfractions of other types of cholesterol.” 

Total cholesterol is designed to be a screening tool, but it may not be accurate to predict those who are actually going to develop heart disease. Heart disease is not influenced by total cholesterol alone; genetics, weight, saturated fat, and trans fat intake all play a role. 

That said, it is still important to monitor your total cholesterol levels and to try to keep them under 200 milligrams per deciliter. What’s the disease risk if your levels are higher than that? 

If your cholesterol is between 200 and 239 milligrams per deciliter, the term is borderline high. If it’s greater than 240, it’s considered high. 

“I’ve been doing this a long time, and I can tell you I’ve watched these targets move,” Professor Anding said. “I remember when I first got into clinical practice, and we didn’t consider cholesterol to be high unless it was greater than 300 milligrams per deciliter. Now we consider that an off-the-chart value.”

Triglyceride Recommendations

The same thing is true for triglycerides. That target is moving, and the maximum recommended values are lower than they were in years past. 

Triglycerides should be less than 150 milligrams when you fast. To be clear, you don’t have to fast to have an accurate total cholesterol reading, but you do have to fast if you want accurate triglyceride data. 

Professor Anding recommends fasting for about eight hours before you have your blood drawn. Even if you’ve had a glass of juice, your triglycerides can be transiently elevated. 

If your triglycerides are in the range of 150 to 199 milligrams, it’s considered borderline high, 200 to 499 milligrams is high, and greater than 500 milligrams is very high.

As it turns out, high triglycerides are now emerging on the scene as a major risk factor for heart disease. Tomorrow’s article delves into the relationship between triglycerides and cholesterol and explains how you can lower your triglycerides.

Professor Roberta H. Anding is a registered dietitian and Director of Sports Nutrition and a clinical dietitian at Baylor College of Medicine and Texas Children’s Hospital. She also teaches and lectures in the Baylor College of Medicine’s Department of Pediatrics, Section of Adolescent Medicine and Sports Medicine, and in the Department of Kinesiology at Rice University.

This article was edited by Kate Findley, Writer for Wondrium Daily, and proofread by Angela Shoemaker, Proofreader and Copy Editor for Wondrium Daily.