"Good" & "Bad" Cholesterol

Low Density Lipoprotein (LDL)

LDL, also know as Lousy Damn Lipid, is the largest risk factor for nasty heart stuff. If you live in an area with hard water, you know what "lime scale" will do to your coffee pot, right? Same with LDL in your body. It's the infamous "plaque" that builds up inside our blood vessels, choking them off and leading to blood clots that lead to heart attacks that lead to really, really, really bad days.

LDL traffic lights are broken

LDL really doesn't have green-yellow-red ranges. You might see published numbers that say LDL should by under 100 mg/dL, but that's only true for people with no risk factors for heart disease. None. Zero. Zip. Nada. Sorry, but diabetes IS a risk factor for heart disease, so our target is 70. In the trenches, 70 is really hard to get to, so many clinicians will say "as close to 70 as possible." What all this boils down to is that if you're at 100 or greater, you'll need to be medicated.

High Density Lipoprotein (HDL)

HDL is the white hat hero of our melodrama. I always like to think about HDL as the Dow Scrubbing Bubbles from the TV commercials. Remember them? They were little animated swirling brushes that cleaned toilets. Anyway, HDL "scrubs" the LDL buildup out of your blood vessels. The higher the HDL, the more it can counteract the negative effects of LDL. Naturally, for lowest heart disease risk, you'd want a low LDL and a high HDL.

HDL: Two green lights, a red light, but no yellow light?

So, with HDL, the higher the better. HDL greater than 40 in men, and greater than 50 in women, is considered the green light zone. But being above 60 is a double green light, earning the title of being "protective" against heart disease. So, getting a HDL above 60 is kinda like getting a medal for valor — going above and beyond the call of duty.

On the other end of the spectrum, any HDL below 40 is considered a "major risk factor" for heart disease.

Take another Tylenol — it gets even more complicated.

But it isn't as simple as just keeping your LDL and HDL in the green-light zones, because there's a relationship between LDL and HDL. Remember that HDL works to counteract the effects of LDL. So if your good cholesterol is outrageously good, you can slide a little on the bad cholesterol. This relationship is sometimes expressed as a ratio of your bad cholesterol to your good. These ratios can be used to assign the relative heart disease risk your lipids place you in, but there are several different standards with enough traffic lights to cause total gridlock; and on top of that, the American Heart Association recommends just looking at the "pure" numbers instead of ratios. They feel ratios express risk without offering any perspective on treatment. In other words, what's the point of knowing your ratio is a yellow light without knowing what type of cholesterol you need to fix?

More fun with heart attacks

So if you haven't had enough fun yet, you can plug in your personal numbers into this Risk Assessment Tool for estimating your 10-year risk for having a heart attack and find out your person 10-year risk of having a heart attack. The only numbers you'll need are your age, gender, total cholesterol, HDL, whether or not you smoke, your systolic blood pressure (the first number), and whether or not you take any medication for high blood pressure. It'll only take you about 15 seconds to enter the data and press the "Calculate Your 10-Year Risk" button.

Summary

The total cholesterol green light is less than 200 mg/dL.
The total cholesterol yellow light is between 200 and 239.
The total cholesterol red light is more than 240.

The triglyceride green light is anything under 150 mg/dL.
The triglyceride yellow light is between 150 and 199.
The triglyceride red light is anything above 200.

The LDL cholesterol green light is as close to 70 mg/dL as humanly possible.
LDL cholesterol has yellow and red lights.

The HDL cholesterol green light for ladies is more than 50 mg/dL.
The HDL cholesterol green light for gentlemen is more than 40.
HDL cholesterol has no yellow lights; but you get a bonus double green light for being above 60.
The HDL cholesterol red light is less than 40.

 

Read Diabetes by the Numbers in full

 

 

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Last Modified Date: July 01, 2013

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