Your cholesterol numbers, demystified (and how to improve them)

Our cheat sheet can help you navigate your test results and understand what your numbers mean.

how to know if you have high cholesterol

You’ve probably been getting your cholesterol levels checked at your annual wellness visit or physical for years. You may even be on medication to control it if your numbers have been high in the past.

Those are both great preventive health practices, since unhealthy cholesterol levels can increase your chances of heart disease and stroke. High cholesterol has no symptoms, which makes screenings super important, especially for older adults.

That’s because your risk of high cholesterol goes up as you get older. It’s most commonly diagnosed in people ages 40 to 59, according to the National Heart, Blood, and Lung Institute. Adults age 65 and older should have their cholesterol checked annually.

But what do all those numbers mean? Knowing your HDLs from your LDLs can be confusing for sure. Here’s a cheat sheet to help you navigate the numbers of your next test.

First, some cholesterol basics

Cholesterol is a waxy substance that’s made in the liver. It is also found in some foods such as meat, egg yolks, and dairy products.

Your body needs cholesterol to function. But when you have too much LDL cholesterol (the “bad” kind), it can cause problems. Over time, extra cholesterol can combine with other substances in the blood to form plaque, which sticks to the walls of your arteries, making them narrower. This can block blood to your heart and other organs.

Are you ready for your next annual wellness visit?

Call your primary care provider to schedule an appointment. If you don’t have a PCP, you can use Find a Doctor on hmsa.com to search for a participating provider near you.

Find a doctor

What a cholesterol test measures

A cholesterol test (also called a lipid profile) checks the amount of cholesterol and triglycerides in your blood. (More on what triglycerides are below.)

If your levels are high, your doctor will likely recommend a plan to lower them. It’s important to know that your cholesterol levels are just one factor that your doctor uses to predict your risk of heart disease, according to the American Heart Association. Other factors include family health history, whether you smoke, whether you have high blood pressure or diabetes, and more.

When you get a cholesterol test, blood is drawn from your arm and sent to a lab. You may need to fast for 12 hours before the test. The results will include:
Total cholesterol: This is the total amount of cholesterol circulating in your blood. It includes low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol plus 20% of triglyceride.

LDL (bad) cholesterol: The main source of cholesterol buildup and blockage in arteries. You want low levels of LDL.

HDL (good) cholesterol: Helps to “sweep out” bad cholesterol from your arteries. You want high levels of HDL.

Triglycerides: Triglycerides are another form of fat in your blood that can raise your risk of heart disease.

What cholesterol numbers are normal?

According to NHLBI guidelines, the numbers below are generally considered normal for most adults. The numbers are in milligrams per deciliter (mg/dL):

Total cholesterol: Below 200 mg/dL
LDL cholesterol: Less than 100 mg/dL
HDL cholesterol: 60 mg/dL or higher
Triglycerides: Less than 150 mg/dL

But there’s not a hard and fast number that every person should be aiming for. The numbers that are right for you can vary depending on your health history, gender, age, and other factors.

What numbers mean my cholesterol is high?

The numbers below are considered borderline high or high for most adults. Your provider can help you understand what they mean for you.

Total cholesterol:

200 to 239 (borderline high)
240 and above (high)

LDL cholesterol:

100 to 129 (near optimal)
130 to 159 (borderline high)
160 to 189 (high)
190 and above (very high)

Triglycerides:

150 to 199 (borderline high)
200 to 499 (high)
500 or above (very high)

HDL:
With HDL, higher levels are actually better. Here are the low levels that put you in the “at risk” category:

For women: 50 mg/dL or lower
For men: 40 mg/dL or lower

How can I lower my cholesterol?

Unhealthy habits are the most common cause of high cholesterol, according to the NHLBI. The good news is that you can make changes to your daily habits. You can’t change factors such as family health history, race, and age.

Here are some tips for healthier habits:

Eat a heart-healthy diet. Try to reduce the amount of saturated fat in your diet. This can help lower your LDL cholesterol. Cut back on fried foods, full-fat dairy products, desserts, and red meat. Eat more colorful fruits and vegetables, whole grains, lean proteins such as fish and turkey, and low-fat dairy.
Move more. Physical activity can increase your HDL cholesterol. Aim to get 30 minutes of moderate aerobic exercise on most days of the week. Options include walking, biking, gardening, and swimming.
Lose weight if you need to. Are you overweight or obese? Extra body fat slows down your body’s ability to remove LDL, according to the Centers for Disease Control and Prevention (CDC).
Quit smoking. Smoking cigarettes raises LDL cholesterol and lowers HDL. Do your heart a favor and kick the habit.
Manage stress levels. Chronic stress can raise your LDL cholesterol and lower your HDL cholesterol.
Cut back on alcohol. Drinking too much wine, beer, or spirits can raise your cholesterol and triglyceride levels, according to the CDC.

Your doctor might suggest that you take medication, such as a statin, to help bring down your LDL cholesterol. Together, you can come up with a plan for how to manage your cholesterol and decide when to schedule your next screening.

Additional sources:
Age and cholesterol: National Heart, Lung, and Blood Institute
Cholesterol and risk assessment: American Heart Association
Normal and high cholesterol levels: National Heart, Lung, and Blood Institute; Mayo Clinic
Risk factors: National Heart, Lung, and Blood Institute
Overweight and high cholesterol: Centers for Disease Control and Prevention

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