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Cholesterol, The Basics

© Gerald Eisman

You’ve heard about cholesterol in every known media form in the world. Newspapers carry articles about it, reporters on the radio discuss the relative merits and demerits of it, and there isn’t a month goes by that you can’t find documentaries about it on your television. The question that begs an answer is, exactly what is cholesterol and why is it so important?

Cholesterol travels in the blood in a bundle called a lipoprotein. Just like oil and water, cholesterol, which is fatty, and blood, which is watery, do not mix. In order to be able to travel in the bloodstream, the cholesterol made in the liver is combined with protein, making a lipoprotein. This lipoprotein then carries the cholesterol through the system. There are specific kinds of lipoproteins that contain cholesterol in your blood, and each affects your heart disease risk in a different way.

Low Density Lipoproteins

One of these lipoproteins is called LDL or Low Density Lipoproteins. This is considered the “lousy” or bad cholesterol that flows through your blood vessels. Following earlier guidelines, your risk of heart problems was measured by total serum cholesterol. If this figure was above 200 milligrams per deciliter (a unit of measure), a complete lipoprotein profile was ordered.

There are new recommendations now, and the change is stark. People are now told that it would be advantageous for all adults over the age of 20 have a fasting blood lipoprotein profile done. That includes low density, high density and triglyceride levels to be determined. This test should be taken at a minimum of every 5 years.

It is imperative that the person taking the test not eat prior to giving blood (fasting blood level) in order that readings all be valid. LDL readings are invalid from non-fasting samples. The overall reading of less than 200 milligrams per deciliter is still used as the desirable level, a new focus of under 100 mgm/dl for LDL is now the ideal target.

High Density Lipoproteins

HDL or High Density Lipoproteins is the good (happy) lipoprotein in your blood. The higher the level of this lipoprotein in your blood, the lower your risk of heart disease will be. The old standard said that under 35 mgm/dl was too low. Today’s recommendations state that under 40 mgm is the new “too low” level. It is also noted that over 60 mgm is too high. Therefore the proper level of HDL would be between 40 and 60 mgm.

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