What It Is and What to Do About It

Written by Jodi Helmer

• Cholesterol Tests
• Make Changes in the Kitchen
• Read Food Labels
• Get Moving
• Lose Extra Weight
• Quit Smoking
• Check to See What’s Working
• More

Has your doctor told you that you have “borderline” high cholesterol? That means your cholesterol level is above normal but not quite in the “high” range.

You have borderline high cholesterol if your total cholesterol is between 200 and 239 milligrams per deciliter (mg/dL).

Your doctor will also consider other things, like how much of your total cholesterol is LDL (“bad”) cholesterol and how much of it is HDL (“good”) cholesterol.

Making simple changes in your lifestyle is often enough to bring borderline cholesterol levels down to the normal range. Some people may also need to take medicine for it. And keep in mind that other things, like diabetes, high blood pressure, and smoking, also affect your heart health; it’s not just about cholesterol.

If you have borderline cholesterol, your doctor will decide whether you need treatment by looking at these and other risk factors for heart disease. They may ask you to get an imaging test of your heart called a coronary artery calcium (CAC) scan. This test reveals whether dangerous plaque has built up in your heart’s arteries.

You won’t know you have borderline cholesterol unless you get a cholesterol blood test. You should do that every 5 years.

The average American has a total cholesterol level of 200, which is in the borderline range.

You can turn it around before you get high cholesterol. Start with these steps.

Why Do I Need a Cholesterol Test?

Cholesterol is a waxy, fat-like substance. Your liver makes all the cholesterol your body needs. But you take in more cholesterol from certain foods, such as those from animals. If you have too much cholesterol in your body, it can build up in the walls of your arteries (as “plaque”) and eventually harden. This process, called atherosclerosis, actually narrows the arteries, making it harder for blood to travel through them. 

Unfortunately, high cholesterol doesn’t cause symptoms. In later stages of atherosclerosis, though, you may have angina – severe chest pain from lack of blood flow to the heart. If an artery gets totally blocked, a heart attack results. A routine blood cholesterol test is a far better way of finding out what your cholesterol level is.

What Does a Cholesterol Test Measure?

In addition to measuring the total cholesterol in your blood, the standard cholesterol test (called a “lipid panel”) measures three specific kinds of fat:

Low-density lipoproteins (LDL). This is the “bad cholesterol,” the main cause of plaque buildup, which increases your risk of heart disease. In general, the lower the number, the better. But LDL cholesterol is only one part of a larger equation that measures a person’s overall risk of having a heart attack or stroke.  

For years, guidelines focused on specific target numbers for people to achieve to lower their risk. The most recent guidelines focus on a person’s overall risk and, based on that risk, recommend a certain percentage of LDL reduction as one part of a way to prevent serious heart and blood vessel problems.

High-density lipoproteins (HDL). This is the “good cholesterol.” It transports bad cholesterol from the blood to the liver, where it is excreted by the body. Your HDL is another part of the equation that identifies the risk of a cardiovascular event. In general, the higher the number the better, although, as with LDL, the emphasis has shifted from specific target numbers to ways to reduce the overall risk.

Triglycerides. Another type of fat in the bloodstream, triglycerides are also linked to heart disease. They are stored in fat cells throughout the body.

What Do Cholesterol Test Numbers Mean?

If you have a lipoprotein profile, it’s important to look at all the numbers from the cholesterol test, not just the total cholesterol number. That’s because LDL and HDL levels are two top signs of potential heart disease. Use the information below to interpret your results (with the help of your doctor, of course). This will help you get a better idea about your risk for heart disease.

Total blood cholesterol level:

• High risk: 240 mg/dL and above
• Borderline high risk: 200-239 mg/dL
• Desirable: Less than 200 mg/dL

LDL cholesterol levels:

190 mg/dL and above represents a high risk for heart disease and is a strong sign that you can benefit from intensive treatment, including lifestyle changes, diet, and statin therapy for reducing that risk.

For LDL levels that are equal to or less than 189 mg/dL, the guidelines recommend strategies for lowering LDL by 30% to 50%, depending on what other risk factors you have that can affect the health of your heart and blood vessels.

HDL cholesterol:

• High risk: Less than 40 mg/dL for men and less than 50 mg/dL for women

Triglycerides:

• Very high risk: 500 mg/dL and above
• High risk: 200-499 mg/dL
• Borderline high risk: 150-199 mg/dL
• Normal: Less than 150 mg/dL

Use your diet to help lower your LDL cholesterol and raise your HDL cholesterol.

For the biggest impact, choose foods that are low in saturated fats and trans fats, and high in fiber, antioxidants, and omega-3 fatty acids. Whole grains, beans, apples, pears, oatmeal, salmon, walnuts, and olive oil are excellent heart-healthy choices.

Here are some more diet tips to help you lower your cholesterol:

Make meat lean. Cut back on red meats that are high in saturated fat and cholesterol, and choose only lean meats with very little visible fat. Examples of lean beef include London broil, eye of round, and filet mignon. Avoid processed meats like bacon and sausage, which are linked to higher odds of heart disease and diabetes.

Remove skin from poultry. That’s where much of the fat is.

Eat more seafood. It usually has less fat than other meat. The American Heart Association recommends eating two servings of fatty fish (like salmon, tuna, or mackerel) each week for heart health. Those fish are good sources of omega-3 fatty acids, which are good for you.

Limit saturated fat. These are found in whole-fat dairy products, mayonnaise, and hydrogenated or partially hydrogenated oils or fats (such as stick margarine). These products may also contain trans fats, which can raise your cholesterol level.

Go liquid. For cooking, replace saturated fats that are solid at room temperature (such as butter and shortening) with liquid monounsaturated fats such as olive, canola, and flaxseed oils. There’s evidence that eating moderate amounts of monounsaturated fat – found in such foods as nuts, seeds, and avocados – may lower LDL cholesterol.

Add fiber with plant foods. Good sources include grapefruit, apples, beans and other legumes, barley, carrots, cabbage, and oatmeal.

Get two daily servings of plant sterol-rich foods. These foods, such as nuts, can help lower cholesterol. Plant sterols are also added to some soft margarines, granola bars, yogurts, and orange juice.

You need to know how much saturated fat, trans fat, and cholesterol are in your favorite foods. That can help you make better choices.

Too much saturated fat can drive up your cholesterol level. It’s found mostly in animal products. Cholesterol also is found in animal products. Your doctor or a dietitian can let you know what your daily limit should be.

Artificial trans fats can raise your LDL (“bad”) cholesterol. They’re in packaged foods, like some crackers, cookies, pastries, and microwave popcorn.

Check the nutrition label. And because products marked “0 grams” of trans fats per serving can have up to a gram of trans fats, check the ingredients label, too. Anything marked “partially hydrogenated” is trans fat.

Exercise helps you get your cholesterol down from the borderline range.

Aim for at least 30 minutes of moderate-intensity exercise, such as brisk walking, per day (150 minutes each week). You can also do a more intense workout for 75 minutes a week.

Taking a walk, riding your bike, playing a team sport, or taking a group fitness class will increase your heart rate while raising HDL (“good”) cholesterol. Push yourself, if you can, but keep in mind that moderate exercise is better than none at all.

You can have borderline high cholesterol and be at a healthy weight. But if you’re overweight, losing those extra pounds can help bring your cholesterol level back down.

Losing as little as 5% of your body weight can lower your cholesterol levels. One study found that adults who took part in a 12-week exercise program lowered their LDL by 18 points, and their total cholesterol dropped 26 points.

With a combination of weight loss and a healthy diet, it’s possible to lower LDL levels up to 30% – results that are similar to taking cholesterol-lowering drugs.

If you’re not sure whether your weight is in a healthy place, ask your doctor to check your body mass index (BMI). A normal BMI is 18 to 25. If your BMI is 25 or higher, ask your doctor for advice on the best types of physical activity for you.

If you smoke, kicking the habit can help raise your HDL (“good”) cholesterol up to 10%.

Have you tried to quit smoking before? For many people, it takes a couple of tries. Keep trying until it sticks. It’s worth it, for your whole body’s health.

During regular screening appointments, your doctor will check your cholesterol levels to see if the changes you’ve made have gotten you to your cholesterol goal.

If lifestyle changes aren’t enough to lower borderline high cholesterol, your doctor may talk to you about medication.

Top Picks

What It Is and What to Do About It

Written by Jodi Helmer

• Cholesterol Tests
• Make Changes in the Kitchen
• Read Food Labels
• Get Moving
• Lose Extra Weight
• Quit Smoking
• Check to See What’s Working
• More

Has your doctor told you that you have “borderline” high cholesterol? That means your cholesterol level is above normal but not quite in the “high” range.

You have borderline high cholesterol if your total cholesterol is between 200 and 239 milligrams per deciliter (mg/dL).

Your doctor will also consider other things, like how much of your total cholesterol is LDL (“bad”) cholesterol and how much of it is HDL (“good”) cholesterol.

Making simple changes in your lifestyle is often enough to bring borderline cholesterol levels down to the normal range. Some people may also need to take medicine for it. And keep in mind that other things, like diabetes, high blood pressure, and smoking, also affect your heart health; it’s not just about cholesterol.

If you have borderline cholesterol, your doctor will decide whether you need treatment by looking at these and other risk factors for heart disease. They may ask you to get an imaging test of your heart called a coronary artery calcium (CAC) scan. This test reveals whether dangerous plaque has built up in your heart’s arteries.

You won’t know you have borderline cholesterol unless you get a cholesterol blood test. You should do that every 5 years.

The average American has a total cholesterol level of 200, which is in the borderline range.

You can turn it around before you get high cholesterol. Start with these steps.

Why Do I Need a Cholesterol Test?

Cholesterol is a waxy, fat-like substance. Your liver makes all the cholesterol your body needs. But you take in more cholesterol from certain foods, such as those from animals. If you have too much cholesterol in your body, it can build up in the walls of your arteries (as “plaque”) and eventually harden. This process, called atherosclerosis, actually narrows the arteries, making it harder for blood to travel through them. 

Unfortunately, high cholesterol doesn’t cause symptoms. In later stages of atherosclerosis, though, you may have angina – severe chest pain from lack of blood flow to the heart. If an artery gets totally blocked, a heart attack results. A routine blood cholesterol test is a far better way of finding out what your cholesterol level is.

What Does a Cholesterol Test Measure?

In addition to measuring the total cholesterol in your blood, the standard cholesterol test (called a “lipid panel”) measures three specific kinds of fat:

Low-density lipoproteins (LDL). This is the “bad cholesterol,” the main cause of plaque buildup, which increases your risk of heart disease. In general, the lower the number, the better. But LDL cholesterol is only one part of a larger equation that measures a person’s overall risk of having a heart attack or stroke. 

For years, guidelines focused on specific target numbers for people to achieve to lower their risk. The most recent guidelines focus on a person’s overall risk and, based on that risk, recommend a certain percentage of LDL reduction as one part of a way to prevent serious heart and blood vessel problems.

High-density lipoproteins (HDL). This is the “good cholesterol.” It transports bad cholesterol from the blood to the liver, where it is excreted by the body. Your HDL is another part of the equation that identifies the risk of a cardiovascular event. In general, the higher the number the better, although, as with LDL, the emphasis has shifted from specific target numbers to ways to reduce the overall risk.

Triglycerides. Another type of fat in the bloodstream, triglycerides are also linked to heart disease. They are stored in fat cells throughout the body.

What Do Cholesterol Test Numbers Mean?

If you have a lipoprotein profile, it’s important to look at all the numbers from the cholesterol test, not just the total cholesterol number. That’s because LDL and HDL levels are two top signs of potential heart disease. Use the information below to interpret your results (with the help of your doctor, of course). This will help you get a better idea about your risk for heart disease.

Total blood cholesterol level:

• High risk: 240 mg/dL and above
• Borderline high risk: 200-239 mg/dL
• Desirable: Less than 200 mg/dL

LDL cholesterol levels:

190 mg/dL and above represents a high risk for heart disease and is a strong sign that you can benefit from intensive treatment, including lifestyle changes, diet, and statin therapy for reducing that risk.

For LDL levels that are equal to or less than 189 mg/dL, the guidelines recommend strategies for lowering LDL by 30% to 50%, depending on what other risk factors you have that can affect the health of your heart and blood vessels.

HDL cholesterol:

• High risk: Less than 40 mg/dL for men and less than 50 mg/dL for women

Triglycerides:

• Very high risk: 500 mg/dL and above
• High risk: 200-499 mg/dL
• Borderline high risk: 150-199 mg/dL
• Normal: Less than 150 mg/dL

Use your diet to help lower your LDL cholesterol and raise your HDL cholesterol.

For the biggest impact, choose foods that are low in saturated fats and trans fats, and high in fiber, antioxidants, and omega-3 fatty acids. Whole grains, beans, apples, pears, oatmeal, salmon, walnuts, and olive oil are excellent heart-healthy choices.

Here are some more diet tips to help you lower your cholesterol:

Make meat lean. Cut back on red meats that are high in saturated fat and cholesterol, and choose only lean meats with very little visible fat. Examples of lean beef include London broil, eye of round, and filet mignon. Avoid processed meats like bacon and sausage, which are linked to higher odds of heart disease and diabetes.

Remove skin from poultry. That’s where much of the fat is.

Eat more seafood. It usually has less fat than other meat. The American Heart Association recommends eating two servings of fatty fish (like salmon, tuna, or mackerel) each week for heart health. Those fish are good sources of omega-3 fatty acids, which are good for you.

Limit saturated fat. These are found in whole-fat dairy products, mayonnaise, and hydrogenated or partially hydrogenated oils or fats (such as stick margarine). These products may also contain trans fats, which can raise your cholesterol level.

Go liquid. For cooking, replace saturated fats that are solid at room temperature (such as butter and shortening) with liquid monounsaturated fats such as olive, canola, and flaxseed oils. There’s evidence that eating moderate amounts of monounsaturated fat – found in such foods as nuts, seeds, and avocados – may lower LDL cholesterol.

Add fiber with plant foods. Good sources include grapefruit, apples, beans and other legumes, barley, carrots, cabbage, and oatmeal.

Get two daily servings of plant sterol-rich foods. These foods, such as nuts, can help lower cholesterol. Plant sterols are also added to some soft margarines, granola bars, yogurts, and orange juice.

You need to know how much saturated fat, trans fat, and cholesterol are in your favorite foods. That can help you make better choices.

Too much saturated fat can drive up your cholesterol level. It’s found mostly in animal products. Cholesterol also is found in animal products. Your doctor or a dietitian can let you know what your daily limit should be.

Artificial trans fats can raise your LDL (“bad”) cholesterol. They’re in packaged foods, like some crackers, cookies, pastries, and microwave popcorn.

Check the nutrition label. And because products marked “0 grams” of trans fats per serving can have up to a gram of trans fats, check the ingredients label, too. Anything marked “partially hydrogenated” is trans fat.

Exercise helps you get your cholesterol down from the borderline range.

Aim for at least 30 minutes of moderate-intensity exercise, such as brisk walking, per day (150 minutes each week). You can also do a more intense workout for 75 minutes a week.

Taking a walk, riding your bike, playing a team sport, or taking a group fitness class will increase your heart rate while raising HDL (“good”) cholesterol. Push yourself, if you can, but keep in mind that moderate exercise is better than none at all.

You can have borderline high cholesterol and be at a healthy weight. But if you’re overweight, losing those extra pounds can help bring your cholesterol level back down.

Losing as little as 5% of your body weight can lower your cholesterol levels. One study found that adults who took part in a 12-week exercise program lowered their LDL by 18 points, and their total cholesterol dropped 26 points.

With a combination of weight loss and a healthy diet, it’s possible to lower LDL levels up to 30% – results that are similar to taking cholesterol-lowering drugs.

If you’re not sure whether your weight is in a healthy place, ask your doctor to check your body mass index (BMI). A normal BMI is 18 to 25. If your BMI is 25 or higher, ask your doctor for advice on the best types of physical activity for you.

If you smoke, kicking the habit can help raise your HDL (“good”) cholesterol up to 10%.

Have you tried to quit smoking before? For many people, it takes a couple of tries. Keep trying until it sticks. It’s worth it, for your whole body’s health.

During regular screening appointments, your doctor will check your cholesterol levels to see if the changes you’ve made have gotten you to your cholesterol goal.

If lifestyle changes aren’t enough to lower borderline high cholesterol, your doctor may talk to you about medication.

Top Picks

Total cholesterol conversion to mmol/l, µmol/l, mg/dl, mg/100ml, mg%, mg/l, µg/ml. Online calculator / converter of traditional units to SI units

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Synonym

cholesterol, cholesterol

Units

mmol/l, µmol/l, mg/dl, mg/100ml, mg%, mg/l, µg/ml

Cholesterol is a steroid with a secondary hydroxyl group at the C3 position. It is synthesized in many tissues, but predominantly in the liver and intestinal wall. Approximately three-quarters of cholesterol is synthesized by the body itself, and a quarter comes from food.

Cholesterol is synthesized throughout the body and is an essential component of cell membranes and lipoproteins; it is also a precursor for the synthesis of steroid hormones and bile acids.

Cholesterol is transported by two classes of lipoproteins (low density lipoproteins and high density lipoproteins), each of which plays an opposite role in the pathogenesis of lipid metabolism disorders.

Cholesterol measurement is used to screen for the risk of atherosclerosis, in the diagnosis and treatment of pathologies including elevated cholesterol levels and metabolic disorders of lipids and lipoproteins.

Readings from postprandial patients may be slightly lower than readings from fasted patients.

REFERENCE RANGE

National Cholesterol Education Program Adult Treatment Panel III (NCEP) recommendations

Clinical interpretation according to European Atherosclerosis Society guidelines

General cholesterol – conversion, conversion, recalculation of units of measurement from generally accepted or traditional units to SI units and vice versa mmol / l, μmol / l, mg / dl, mg / 100 ml, mg%, mg / l, μg / ml. Laboratory online calculator. Converting quantitative values ​​of laboratory test results from one unit of measure to another. Table with conversion factors for study results.

Clinical chemistry

If you have high cholesterol – RZD-Medicine, Orsk

What is cholesterol? Moreover, the cells of the body, especially the liver, produce it themselves, so cholesterol from food cannot harm us.

0003

So is cholesterol harmful or beneficial and is it worth fighting it?

Cholesterol is a fat-like substance that is really vital for a person. Cholesterol is part of the shell-membranes of all body cells, it is abundant in nervous tissue, cholesterol is necessary for the formation of many hormones.

But! The body itself produces cholesterol in quantities more than sufficient to meet its own needs. However, a person also receives cholesterol from food. When there is too much cholesterol in the body, first of all, in the blood of a person, then from a friend he turns into a mortal enemy.

How does cholesterol work when there is too much of it?

Excess cholesterol accumulates in the walls of blood vessels. Connective or, in other words, scar tissue grows around these deposits, and calcium deposits form. This forms an atherosclerotic plaque. It narrows the lumen of the vessel, reduces blood flow, and the attachment of a blood clot leads to its blockage.

When a vessel is blocked, the blood flow stops, and the tissue of the organ that fed this vessel gradually dies, without receiving oxygen and nutrients. If the blockage occurs in the heart, angina pectoris develops, and then myocardial infarction, if in the brain, a cerebral stroke.

Sometimes the vessels of the legs are affected, then the person experiences unbearable pain and often loses the ability to move. The first call signaling the risk of developing these diseases is high cholesterol.

Everyone over the age of 20 should know their cholesterol levels. To do this, you just need to regularly – at least once every few years – do a blood test for the level of total cholesterol and its content in various transport forms – lipoproteins.

What do the numbers in the analysis mean?

In the blood test you will see the level of cholesterol (Cholesterol), as well as other numbers. The fact is that in human blood, cholesterol is transported along with proteins, and such complexes are called lipoproteins.

Low-density lipoproteins (LDL) and their very-low-density lipoprotein (VLDL) precursors are low in protein, large, and high in cholesterol and fat—triglycerides. Penetrating into the vessel wall, they transport excess cholesterol into the vascular cell. An increase in the level of these components in the blood leads to the early development of atherosclerosis.

High-density lipoproteins (HDL) are small in size and contain a different protein than LDL. Penetrating into the wall of the vessel, they capture cholesterol and carry it to the liver. The lower the HDL level, ie. cholesterol in “good” complexes, the higher the risk of atherosclerosis.

Optimal levels of cholesterol and related parameters in the blood:

Total cholesterol	< 5.0 mmol/l (190 mg/dl)
LDL cholesterol	< 3.0 mmol/L (115 mg/dL)
Triglycerides (major components of VLDL)	< 1. 7 mmol/l (150 mg/dl)

People who control their cholesterol have 30 to 40 percent fewer serious heart complications and 30 percent fewer deaths from any cause.

What to do if your blood cholesterol level is high?

Cholesterol can be reduced. To do this, you need to improve your lifestyle. Be physically active, eat right and stop smoking – it significantly increases the risk of atherosclerotic plaque formation.

First of all, it is necessary to reduce the consumption of solid animal fats, which simultaneously contain a lot of saturated fatty acids and cholesterol, they are abundant in butter, fatty dairy products, fatty cheeses, rich pastries, fatty meat.

Fats should make up about 30 percent of the total caloric content of food, of which saturated – no more than 10 percent (1/3 of all fats), and 2/3 of fats – should come from the consumption of vegetable oils, fish oil. By following the rules below, you can achieve a 10-12 percent reduction in blood cholesterol levels.

Allowed number of eggs is two per week. But you will also get them as part of salads and pastries.

Eat more low-fat and low-cholesterol foods in your diet, especially low-fat dairy products.

Choose wholemeal bread, whole grain pasta, cereals cooked with water. Eat more vegetables and fruits.

For meat products, stop at chicken, turkey and veal. Before cooking, remove fat from meat, and skin from poultry.

Increase your consumption of fish, especially sea fish. It is better if fish is present in your diet daily.

Choose desserts without fat, cream and a lot of sugar. Stop for fruit salads and unsweetened jellies.

Eat more soluble fiber foods: oatmeal, apples, plums, berries, beans. They lower the level of cholesterol in the body and increase its excretion.

Eat the latest so-called “functional” foods containing plant sterols and stanols, which reduce intestinal absorption of cholesterol and reduce the “bad” form of LDL cholesterol by 10 to 15 percent.

Do not fry in oil: boil, stew, bake. Use cookware with a coating that does not require the addition of fat when cooking.

What if the diet doesn’t work?

If after 6 to 8 weeks of the diet your total cholesterol is less than 5 percent and your risk of atherosclerosis is still high, your doctor may prescribe cholesterol-lowering medications.

Never self-medicate or fall for “miracle” nutritional supplements. The doctor can advise you on only one type of supplement – soluble fiber preparations. However, it is worth remembering that they only complement and enhance the effect of a properly formulated diet.

In Russia, no more than 5 percent of people know their own blood cholesterol level. For comparison: in the US and Europe, this figure is almost 80 percent.

Studies show that an average 10 percent reduction in cholesterol levels results in a 20 to 50 percent reduction in the risk of major cardiovascular disease and death from them.

Cardiologists around the world believe that every person over 20 years of age should know their cholesterol level.