Cholesterol Numbers and What They Mean

Why are my cholesterol numbers important?

Your cholesterol numbers are important because they help you know your risk for heart disease. Cholesterol is a type of lipid (fat) that helps your body perform many important functions. But too much cholesterol in your blood is bad for you. It can enter your artery wall, damage its integrity and lead to the formation of atherosclerotic plaque (hardened deposits).

This process of plaque buildup is called atherosclerosis. It can lead to serious problems like:

• Coronary artery disease: Blocked blood flow to your heart.
• Peripheral artery disease: Blocked blood flow to your legs and arms.
• Carotid artery disease: Blocked blood flow to your brain.

Cholesterol travels through your blood silently. And it turns into plaque silently. Plaque buildup is like someone tip-toeing on carpet. You might not see or notice its presence for a long time. You may have no symptoms until you have a heart attack or stroke. At that point, the plaque is like high heels on a hardwood floor. And it’s already caused serious damage to your body.

You can live for many years with high cholesterol and not even know it. That’s why it’s essential to get your cholesterol numbers checked on a regular basis. If your cholesterol numbers are too high (hyperlipidemia), that’s a red flag for you and your healthcare provider. High cholesterol is a major risk factor for heart disease. But catching it early gives you a chance to make changes and get your cholesterol to a healthy level.

Cholesterol numbers in the heart-healthy range can help lower your risk of heart disease.

What kind of test measures cholesterol?

Your provider checks your cholesterol levels through a blood test called a lipid panel (or lipid profile). Your provider will draw blood from a vein in your arm and send the blood to a lab for analysis. Be sure to closely follow your provider’s instructions on how to prepare for the test. You’ll likely need to fast for 12 hours beforehand. This means avoiding all foods and drinks except water.

When your results come in, your provider will let you know. You may also be able to access your results through your electronic medical record.

Your lipid panel gives you the following numbers:

• Total cholesterol: This is the total amount of cholesterol that’s circulating in your blood. Here’s the formula for calculating it: HDL + LDL + 20% triglycerides = total cholesterol.
• HDL level: HDL is high-density lipoprotein. This is the “good” cholesterol that moves extra cholesterol from your bloodstream to your liver. Your liver then gets rid of it from your body. When you see HDL, think of “h” for helpful. HDLs help your arteries clear out the cholesterol your body doesn’t need. It’s the one number in your lipid panel that you want to be high.
• LDL level: LDL is low-density lipoprotein. This is the “bad” cholesterol that contributes to plaque buildup in your arteries. You need some LDLs because they carry cholesterol to your body’s cells. But having too many can cause problems.
• VLDL level: VLDL is very low-density lipoprotein. It’s another “bad” form that contributes to plaque buildup. VLDLs carry a type of fat (triglycerides) in your blood. If you have too many VLDLs, the extra fat can build up in your arteries.
• Triglycerides: This is a type of fat. You need some triglycerides. But high levels (hypertriglyceridemia) can put you at risk for atherosclerosis and other diseases.
• Non-HDL cholesterol: This is all the cholesterol in your blood that isn’t HDL. The formula for calculating this number is simple: Total cholesterol – HDL = Non-HDL cholesterol
• Ratio between total cholesterol and HDL: This is your total cholesterol divided by your HDL. In general, you want your number to be below five. Your results may show a chart with more details and desirable levels.

What is the unit of measurement for cholesterol?

Healthcare providers measure cholesterol levels as milligrams of cholesterol per deciliter of blood. The abbreviation is mg/dL. Providers use these same units to measure your triglycerides.

What are normal cholesterol levels?

Normal cholesterol levels vary based on your age and sex assigned at birth.

Normal cholesterol levels by age chart

The chart below shows normal cholesterol levels. Healthcare providers consider these numbers healthy for most people. If you have heart disease or many risk factors, your LDL target may be different. Your healthcare provider may want your LDL level to be below 70 mg/dL. So, it’s important to talk with your provider about your test results and what they mean for you.

All units in the chart below are mg/dL.

As you review your results, remember that you want your LDL to be low and your HDL to be high. Ideally, your HDL should be above 60. It’s the helpful cholesterol. An HDL above 60 offers you protection against heart disease.

Sex-based differences

Most normal cholesterol levels are the same regardless of your sex. But there is one key difference among adults. That’s your HDL number. As the chart above shows, people assigned female at birth need a higher HDL level (at least 50) compared with people assigned male at birth (at least 40).

What’s considered high cholesterol?

High cholesterol generally means your total cholesterol is 200 mg/dL or higher. But providers use additional categories like “borderline high” and “near optimal” to break down your results. If your numbers are close to normal levels, they may be easier to manage through lifestyle and dietary changes.

High cholesterol levels by age chart

The chart below shows cholesterol levels that are higher than normal. All units are mg/dL.

How often should I get my cholesterol checked?

Your provider will tell you how often you need your cholesterol checked. It depends on your:

• Age: The older you get, the more often you need to have your numbers checked.
• Family history: If you have a close biological family member with a history of heart disease, you face a higher risk of heart problems, too. You may need cholesterol tests more often if your family member has high cholesterol or a history of heart attack or stroke.
• Risk factors for heart disease: If you’ve been diagnosed with heart disease or have risk factors, you’ll need cholesterol tests more often.
• Sex assigned at birth: People assigned male at birth need more frequent tests starting at a younger age compared with people assigned female at birth.

Children and teens age 19 and younger should get their first test between ages 9 and 11. Then, they should receive a test every five years. Your child’s provider may recommend starting at a younger age based on family history.

Here are general guidelines for adults based on sex and age.

People assigned male at birth

People assigned female at birth

I just learned I have high cholesterol. Now what?

You may feel upset to learn you have high cholesterol. But now that you know about it, you can take action to lower your numbers.

Follow your provider’s guidance on how to lower your cholesterol and reduce your risk of heart disease. Some general tips include:

• Add more exercise to your daily routine.
• Avoid smoking and all tobacco products.
• Keep a weight that’s healthy for you.
• Learn how food impacts your cholesterol, and start with small changes to your diet.
• Manage high blood pressure and high blood sugar.
• Learn new strategies for dealing with stress.
• Take your medications as prescribed.

Most of all, don’t blame yourself. High cholesterol is a common condition that can be hard to control through lifestyle choices alone. And many factors beyond our control limit the choices we can make.

Be kind to yourself, and remember that your cholesterol numbers don’t define you as a person. They simply give you a window into what’s happening inside your body. Your provider will help you use that information to plan your treatment and keep your arteries healthy for a long time to come.

A note from Cleveland Clinic

Knowing your cholesterol numbers can help you learn your risk for heart disease. But keep in mind that your cholesterol numbers are just part of the story. Your provider will also look at other aspects of your health to learn more about your risks. So, if your numbers fall outside the normal range, don’t panic. Talk with your provider about what your cholesterol levels mean in the context of your overall health. And work with your provider to get your numbers back to a healthier place.