Cholesterol Levels

What is Cholesterol?

Cholesterol is a wax-like substance found in our body cells. 80% of the cholesterol is made by the liver, with only 20% coming from the food you consume. Most people relate cholesterol with diseases and health conditions, whereas in reality, its effects are not always negative. 

While excessive cholesterol can clog your arteries and cause a heart attack, it also has its uses. Surprising as it may sound, cholesterol causes the production of hormones like oestrogen, testosterone, vitamin D, and bile acids. Furthermore, it acts as a vital building block in the cell membranes. 

Due to being fat and waxy, cholesterol can’t move through the bloodstream on its own. Instead, tiny protein molecules called lipoproteins help transport cholesterol in the body. 

The lipids travelling through the bloodstream come in various forms like chylomicrons, VLDL, IDL, LDL, and HDL. Out of them, LDL or Low-Density Lipoprotein is the one that attracts maximum attention. Mostly referred to as bad cholesterol, it is the primary reason behind plaquing and clogged arteries. On the other hand, HDL or High-Density Lipoprotein is known as good cholesterol because it eliminates the excessive LDL in the body by carrying it to the liver. 

How to Determine the Cholesterol Levels in Your Body?

Lipid profile or lipid panel is a cholesterol test that measures cholesterol levels in your body. It is a blood test that determines the following: 

  • Total cholesterol – The total amount of cholesterol, including LDL and HDL
  • LDL – Also known as the bad cholesterol in your blood.
  • HDL – Known as the  good cholesterol in your blood.
  • Triglycerides – A type of non-cholesterol fat found in the body. 
  • Non-HDL – Total cholesterol minus HDL 

The levels are measured in mg/dL (milligrams per deciliter) and presented in a numeric form.

Markers for Different Levels of Cholesterol – Normal, Borderline, and Very high 

Cholesterol normal range for most adults

Total cholesterol Less than 200 mg/dL
LDLLess than 100 mg/dL
HDL40-60 mg/dL
TriglyceridesLess than 150 mg/dL
Non-HDL More than 130 mg/dL

The above table shows the normal range of cholesterol for normal healthy adults. Now, it is time to know about the borderline and high cholesterol range. 

Cholesterol Borderline Numbers for Most Adults

As the name suggests, it refers to marginally high Cholesterol levels. If you have a history of heart diseases or are at risk of developing one, your doctor will suggest and formulate a treatment plan.

Total cholesterol 200-239
Triglycerides 150-199

Cholesterol Very High Levels for Most Adults

Total cholesterol 240 or more
LDL190 or more 
Triglycerides 500 or more 

HDL results 

Below 45Not good
45-60 Normal 
60 and above Very good 

As per The National Cholesterol Education Programme (NCEP) Adult Treatment Panel III Reporting guidelines. 

Why Should You Worry About High cholesterol Levels?

High cholesterol in your blood indicates heightened risk of developing cardiovascular diseases like heart attack and heart failure. Excessively high cholesterol can plaque the walls of the arteries and block them. This, in turn, affects the blood and oxygen carried to your heart, thus increasing the risk of a stroke or heart attack. Besides these, high Cholesterol level can have the following impacts: 

  • Brain strokesAngina
  • Gallstones
  • Peripheral arterial disease
  • Numbness in joints and legs
  • Loss of memory 

What Are Symptoms of High Cholesterol?

Typically, high cholesterol symptoms are hard to detect as they do not create any noticeable symptoms to start with. It creates complications as the level increases.. For example, excessive cholesterol can induce heart attacks and strokes.

Typically, these events do not occur until excessive cholesterol causes the production of arterial plaque. Plaque can restrict arteries, decreasing blood flow. Plaque development alters the composition of the arterial lining. This might result in significant difficulties.

Only a blood test can determine whether your cholesterol is high. The normal levels are determined as per the National Cholesterol Education Programme (NCEP) Adult Treatment Panel III Reporting guidelines. High cholesterol  indicates a total cholesterol level in the blood that is greater than 200 milligrams per deciliter (mg/dL). After the age of 20, it is advisable to get cholesterol tests done. Then, your cholesterol levels should be rechecked every four to six years. If you have a family history of high cholesterol, your doctor may also recommend more frequent cholesterol screenings.

When and How Often Should You Take a Cholesterol Test?

  • Doctors recommend testing cholesterol at the age of 10. 
  • Young adults who are 20 and above should undergo tests every five years.
  • Adults 45 and above should get the tests done every two years. 

Lipid profile tests and Cardiac Risk  Profiles are often recommended regularly to test the overall cholesterol and lipid levels.

Who is at High Risk of Cholesterol?

The following triggers can cause potentially high levels of cholesterol.

How is a Cholesterol Test done?

The tests are conducted in the mornings because you will need to fast for about 9 hours before the test. The physician or lab technician will leave detailed instructions the day before. 

The technician will take a blood sample by inserting a needle in the vein of your arms. The whole test takes only about a couple of minutes. 

What Distinguishes Healthy Cholesterol From Harmful Cholesterol?

The term for good cholesterol is high-density lipoprotein (HDL). It eliminates cholesterol from circulation. The ‘bad’ cholesterol is low-density lipoprotein (LDL).

If you have a high total cholesterol level due to a high LDL level, you may be at an increased risk for heart disease or stroke. However, if your total cholesterol level is elevated only due to a high HDL level, you are not likely at an increased risk.

Triglycerides are an additional form of blood fat. When you consume more calories than your body can utilize, the excess calories are converted into triglycerides.

Diet and activity changes can improve cholesterol readings, reduce LDL and triglycerides, and increase HDL.

Your optimal cholesterol level depends on your cardiovascular disease risk.

What are the normal ranges for cholesterol LDL?

Ideally, the total cholesterol level should be less than 200 mg/dL, depending on HDL and LDL levels.

LDL cholesterol levels – less than 130 is optimal, however, this varies based on heart disease risk.

HDL cholesterol levels of 60 or above minimize the risk of cardiovascular disease.

The optimal level of triglycerides is fewer than 150 milligrams per deciliter (mg/dL).

How to Manage Cholesterol?

  • Include more vegetables, fruits, and whole grains in your diet. 
  • Avoid foods with high-salt content 
  • Limit foods like cakes, butter, Ghee, biscuits, fatty red meat, etc, that contain saturated fats. 
  • Maintain a healthy weight. 
  • Drink alcohol in moderation.
  • Exercise regularly and be physically active. 
  • Avoid stress. 
  • Avoid smoking. 
  • Take the medications prescribed by your doctor. 
  • Have your cholesterol checked every year if you are in the high-risk group and every five years if you don’t have any risk factors. 

There are often no symptoms of high cholesterol, leading the medical community to term it a silent killer. A blood test is the only way to determine cholesterol levels in your body. So, even if you are healthy, it would be advisable to go through routine examinations. However, prevention is always better than cure. If you are a smoker, have blood pressure and uncontrolled diabetes, your risk of developing cholesterol is higher. To keep cholesterol at bay, start practising a healthy lifestyle. Diet is one of the best ways to keep your cholesterol under check. Hence, watch what you eat on a regular basis. Most importantly, curb your alcohol intake and work towards getting a healthy weight. A little cautiousness on your part can go a long way in giving you a better chance at a healthy and fruitful life.

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A heart attack also called myocardial infarction is a serious medical emergency in which the blood supply that brings oxygen to the heart muscle is severely reduced or cut off and the heart muscle begins to suffer damage or start to die. It often results from a blockage in the coronary arteries that feed the heart. The lack of blood supply can cause lasting damage to the heart muscle and can be life threatening.

Heart attack vs cardiac arrest

A heart attack is different from cardiac arrest. In the latter, the heart stops working completely and suddenly stops pumping blood around your body. Both are medical emergencies.

What causes a heart attack?

Coronary heart disease, the leading cause of heart attacks, is a condition in which one or more coronary arteries become narrowed or blocked. The blockage is most often a buildup of fat, cholesterol, calcium, proteins, and inflammatory cells, which form a plaque in the walls of arteries. One of the plaques can rupture, forming a blood clot at the site of the rupture. This blood clot can starve the heart muscle of oxygen by blocking the blood flow through arteries, resulting in a heart attack.

Risk factors like smoking, a high-fat diet, diabetes, high cholesterol, hypertension and obesity can increase your risk of developing coronary heart disease.

People aged 65 or older usually have a higher risk than young adults to get a heart attack.
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A spasm in your coronary artery is another rare cause of heart attacks. During coronary spasm, your arteries restrict or shut down blood flow to part of the heart muscle. Use of tobacco and stimulants such as cocaine can cause a life-threatening spasm.

Symptoms of heart attack

Some people who are having a heart attack have warning signs or symptoms while others show no signs at all. Symptoms of a heart attack that many people report include:

  • Chest pain
  • Pain in upper body
  • Feeling lightheaded
  • Sweating
  • Trouble breathing
  • Nausea or vomiting
  • Coughing or wheezing
  • An overwhelming sense of anxiety

Sleep disturbances, weakness, extreme shortness of breath, indigestion, body aches or discomfort in the back or upper body, a general feeling of being unwell are some atypical heart attack symptoms in females that can occur with or without chest discomfort. Recognizing these early symptoms and seeking immediate medical attention is crucial to save a person’s life.

How can one reduce risk of heart attack?

Adopting a healthier lifestyle is the most effective way to prevent having a heart attack. Lifestyle changes you can make to help prevent a heart attack are:

  • Eat a healthy diet
  • Quit smoking
  • Limit alcohol
  • Control your blood pressure
  • Control your cholesterol and triglyceride levels
  • Maintain a healthy weight
  • Manage diabetes
  • Manage stress
  • Get regular exercise
  • Get enough sleep

Treatment of heart attack

Diagnosis and treatment of heart attack might be complex and different depending on which type of heart blockage you’ve had. A complete blockage means you’ve had an ST elevation myocardial infarction (STEMI) and a partial blockage means you’ve had a non-ST elevation myocardial infarction (NSTEMI).Treatments differ for STEMI versus NSTEMI, although there can be some overlap.

If you have a STEMI, the most serious form of heart attack, get immediate medical assessment and treatment. It is important to get prompt treatment, to unblock your coronary arteries restoring blood flow to part of the heart muscle and minimizing the heart muscle damage. Treatment may involve different techniques like use of clot-dissolving drugs (thrombolysis), coronary angioplasty (percutaneous coronary intervention) or a bypass surgery depending on when your symptoms started and how soon you can access the treatment. Coronary angiography is done first to assess your suitability for coronary angioplasty.

Coronary angioplasty and stenting: In this procedure, also known as percutaneous coronary intervention (PCI), doctors guide a long, thin tube with a sausage-shape balloon at the end (catheter) through an artery in your groin or arm to a blocked artery in your heart. Once the catheter is in position, the balloon is inflated to open a blocked coronary artery and restore blood flow. A flexible metal mesh stent almost always is inserted into the artery to help keep it open afterwards.

You may also be given blood-thinning medicines, such as low-dose aspirin, to prevent further clots from forming. You may need to continue taking these medicines for some time after angioplasty. In some cases, coronary angioplasty may not be technically possible. In such circumstances, coronary artery bypass surgery may be considered as an alternative operation.

Coronary artery bypass surgery:  It involves taking a healthy blood vessel from another part of your body, usually your chest, arm or leg and sewing it to the coronary artery above and below the narrowed or blocked area, allowing blood flow to the heart to bypass the narrowed section.

You’ll likely remain hospitalized for several days after blood flow to your heart is restored and your condition is stable.

If you have the less serious types of heart attack (NSTEMI), blood-thinning drugs (antiplatelet agents and anticoagulants) are usually recommended to inhibit blood clot formation.

The drugs used to break down blood clots, known as thrombolytics or fibrinolytics, are usually given by injection.

In some cases, further treatment with angioplasty or bypass surgery may also be recommended in cases of NSTEMI or unstable angina, after initial treatment with various drugs.

Be aware but don’t panic

Having a heart attack is a frightening experience. A heart attack can be life threatening and requires immediate medical treatment. If anyone has symptoms of a heart attack, access medical care at once. With immediate medical attention, there is often a good chance of a positive outcome.

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Are you aware that your heart, the organ which you usually and casually blame for your unwarranted actions, actually doesn’t control your emotions? It, in fact, allows pumping of blood, oxygen, and nutrients throughout your body. It beats over 100,000 times per day and pumps about 1.5 gallons of blood every minute. It keeps itself superactive so that you can keep going. But are you taking enough care of your heart health? Heart disease has become one among the emerging health issues in developing India.

As per the WHO, more than four out of five heart disease deaths are due to heart attacks and strokes, and one third of these deaths occur prematurely in people below 70 years of age.
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Keep Abreast of Emerging Heart Issues with Health Tests

Smoking, high blood pressure, high cholesterol and diabetes are some of the common risk factors for developing heart conditions. While your doctor is the best guide to help you identify your risk of heart disease, it is important to know that some heart related blood tests hold a lot of importance to diagnose and manage heart conditions.

Top Heart Blood Tests List for Diagnosing Heart Disease

1. Lipid profile test:

Also called cholesterol test, this test measures the levels of fats in your blood and can point out towards your risk of having a heart attack, stroke or other heart disease. This test typically includes measurements of various other numbers:

  • Total cholesterol: This refers to the amount of cholesterol in your blood. An increased level of total cholesterol increases your risk of heart disease. In general, your total cholesterol should be under 200 milligrams per deciliter (mg/dL) or 5.2 millimoles per liter (mmol/L).

  • High-density lipoprotein (HDL) cholesterol: Also called the “good” cholesterol, it helps keep arteries open and your blood to flow more freely.

  • Low-density lipoprotein (LDL) cholesterol: Also called the “bad” cholesterol, too much LDL cholesterol in your blood can lead to plaque deposition in your blood vessels, and results in reduced blood flow. These plaque build up may rupture and cause major heart and blood vessel problems.

  • Triglycerides: These are another type of fat in the blood, high levels of which can raise your risk of heart disease. Your triglyceride level should be less than 150 mg/dL (1.7 mmol/L).

For your reference:
Total cholesterol = HDL cholesterol + LDL cholesterol + 20% of Triglycerides level

2. High-sensitivity C-reactive protein test (hs CRP test)

C-reactive protein (CRP) is a protein which is produced by your liver as part of your body’s response to inflammation that may occur due to an injury or infection. The hs-CRP test can spot lower levels of C-reactive protein (CRP) in your blood. A raised hs-CRP test values indicate a higher risk of heart attack, stroke and cardiovascular disease.

This blood test has a great significance in diagnosing heart conditions as it can help determine your risk of heart disease before you have symptoms. An hs-CRP level above 2.0 mg/L is considered to indicate an increased risk of heart disease.

However, CRP levels can be temporarily increased by many other situations other than a heart disease, like a viral infection. Hence, some experts may suggest doing the test twice, two weeks apart.

Remember, only looking at hs-CRP levels may not be enough to arrive at something definite. Your doctor can ask for other health tests as well, and combine your hs-CRP test and other blood test results with your risk factors to get an overall sense of your heart health.

3. Natriuretic peptides test

Brain natriuretic peptide is a protein that your heart and blood vessels make to help your body eliminate fluids, relax blood vessels and excrete sodium into your urine. When your heart gets damaged, levels of BNP entering your blood increases.

Different people can have different values for normal BNP levels since it can vary based on the age, gender, and being overweight.

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4. Troponin (T) Test for Heart Attack

Troponin (or cardiac troponin) is a type of protein found in your heart muscles. It isn’t normally found in the blood and is released into the blood when heart muscles become damaged.

A troponin test looks for the level of troponin in your blood. As more and more heart muscle gets damaged, greater amounts of troponin are released in the blood. Two types of cardiac troponin T (cTnT) and I (cTnI) are used as cardiac profile test to identify heart injury or damage. A high level of troponin in the blood may indicate you are having or recently had a heart attack.

Some studies have found that troponin I is more specific and a better cardiac marker than troponin T blood test for heart attack.

Remember that one heart blood test alone may not determine your overall risk of heart disease. If you think your lifestyle or family history can put you at risk of developing heart disease at an early age, get in touch with a doctor, book yourself blood test for heart blockage and heart Disease as advised, and improve your lifestyle habits.

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