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Cholesterol levels: What numbers should you aim for?
Figuring out the best cholesterol levels to aim for can be confusing. But here's some help setting your cholesterol number targets.
By Mayo Clinic staffIt's important to keep your cholesterol levels within healthy limits. And if you have other risk factors for developing heart disease, you need to be even more careful — especially with your low-density lipoprotein (LDL), or "bad," cholesterol level.
Interpreting your cholesterol numbers
Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood in the United States and some other countries. Canada and most European countries measure cholesterol in millimoles (mmol) per liter (L) of blood. Consider these general guidelines when you get your lipid panel (cholesterol test) results back to see if your cholesterol falls in optimal levels.
| Total cholesterol (U.S. and some other countries) | Total cholesterol* (Canada and most of Europe) | |
|---|---|---|
| Below 200 mg/dL | Below 5.2 mmol/L | Desirable |
| 200-239 mg/dL | 5.2-6.2 mmol/L | Borderline high |
| 240 mg/dL and above | Above 6.2 mmol/L | High |
| LDL cholesterol (U.S. and some other countries) | LDL cholesterol* (Canada and most of Europe) | |
|---|---|---|
| Below 70 mg/dL | Below 1.8 mmol/L | Optimal for people at very high risk of heart disease |
| Below 100 mg/dL | Below 2.6 mmol/L | Optimal for people at risk of heart disease |
| 100-129 mg/dL | 2.6-3.3 mmol/L | Near optimal |
| 130-159 mg/dL | 3.4-4.1 mmol/L | Borderline high |
| 160-189 mg/dL | 4.1-4.9 mmol/L | High |
| 190 mg/dL and above | Above 4.9 mmol/L | Very high |
| HDL cholesterol (U.S. and some other countries) | HDL cholesterol* (Canada and most of Europe) | |
|---|---|---|
| Below 40 mg/dL (men) Below 50 mg/dL (women) |
Below 1 mmol/L (men) Below 1.3 mmol/L (women) |
Poor |
| 50-59 mg/dL | 1.3-1.5 mmol/L | Better |
| 60 mg/dL and above | Above 1.5 mmol/L | Best |
| Triglycerides (U.S. and some other countries) | Triglycerides* (Canada and most of Europe) | |
|---|---|---|
| Below 150 mg/dL | Below 1.7 mmol/L | Desirable |
| 150-199 mg/dL | 1.7-2.2 mmol/L | Borderline high |
| 200-499 mg/dL | 2.3-5.6 mmol/L | High |
| 500 mg/dL and above | Above 5.6 mmol/L | Very high |
*Canadian and European guidelines differ slightly from U.S. guidelines. These conversions are based on U.S. guidelines.
LDL targets differ
Because LDL cholesterol has a major association with heart disease, it's the main focus of cholesterol-lowering treatment. But it's not as simple as the chart may appear. Your target LDL number can vary, depending on your underlying risk of heart disease.
Most people should aim for an LDL level below 130 mg/dL (3.4 mmol/L). If you have other risk factors for heart disease, your target LDL may be below 100 mg/dL (2.6 mmol/L). If you're at very high risk of heart disease, you may need to aim for an LDL level below 70 mg/dL (1.8 mmol/L).
So who's considered at very high risk? If you've had a heart attack or if you have diabetes or carotid or peripheral vascular disease, you're at very high risk. In addition, two or more of the following risk factors might also place you in the very high risk group:
- Smoking
- High blood pressure
- Low HDL cholesterol
- Family history of early heart disease
- Age older than 45 if you're a man, or older than 55 if you're a woman
- Elevated lipoprotein (a)
Types of cholesterol
LDL cholesterol can build up on the inside of artery walls, contributing to artery blockages that can lead to heart attacks. Higher LDL cholesterol levels mean higher risk. High-density lipoprotein (HDL) cholesterol is known as "good" cholesterol because it helps prevent arteries from becoming clogged. Higher HDL cholesterol levels generally mean lower risk.
A blood test to check cholesterol levels — called a lipid panel or lipid profile — typically reports:
- Total cholesterol
- HDL cholesterol
- LDL cholesterol
- Triglycerides, a type of fat often increased by sweets and alcohol
For the most accurate measurements, don't eat or drink anything (other than water) for nine to 12 hours before the blood sample is taken.
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