Ldl 203: Total Cholesterol: 203 mg/dL
Total Cholesterol: 203 mg/dL
Elle Penner, MPH, RD
What does a total cholesterol level of 203 mean? Are there any symptoms associated with this level?
A total cholesterol level of 203 mg/dL is considered elevated. Although cholesterol serves several important functions in the body, elevated cholesterol may put you at greater risk for heart disease.
Your total cholesterol is calculated by adding your LDL (bad) cholesterol, HDL (good) cholesterol, and 20% of triglyceride levels.
LDL is often referred to as “bad” cholesterol because it accumulates in your blood vessels and increases your risk for heart disease. Ideally, LDL levels should be less than 100 mg/dL, but lower is better.
HDL is considered “good” cholesterol because it protects against heart disease by scavenging cholesterol and returning it to the liver for excretion. The ideal HDL level is >60 mg/dL, though >40 mg/dL for men and >50 mg/dL for women are still considered good.
Triglycerides are another type of fat that can build up in the bloodstream and increase your risk of heart disease. Ideally, triglycerides should be <150 mg/dL.
Elevated cholesterol doesn’t have symptoms, which is why it’s important to know your levels. Lowering your total cholesterol will reduce your risk of developing heart disease and other health issues. If you already have heart disease, lowering your cholesterol can reduce your odds of serious complications, like a heart attack or stroke.
Factors that could contribute to a total cholesterol level of 203:
Diet: Diets that are high in saturated fats, trans fats, added sugar, and low in fiber can cause blood cholesterol to rise.
Weight. Being overweight also tends to increase cholesterol levels.
Physical Activity. Being active can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels.
Smoking: Smoking lowers your HDL (good) cholesterol, which can contribute to a higher level of bad cholesterol.
Medications: Some medications can increase cholesterol levels including corticosteroids, beta-blockers, thiazide diuretics, retinoids, growth hormones, and antivirals.
Diseases: Certain diseases like chronic kidney disease, diabetes, and HIV/AIDS can elevate total cholesterol.
Age and Sex: Premenopausal women tend to have lower total cholesterol levels than men of the same age. However, cholesterol levels tend to increase with age in both women and men. After the age of menopause, women’s LDL (bad) cholesterol levels tend to rise.
Genetics (heredity): High blood cholesterol can run in families. This is because your genes partly determine how much cholesterol your body makes.
Race: Certain races may have an increased risk of high blood cholesterol. For example, Blacks/African Americans typically have higher HDL and LDL cholesterol levels than Caucasians.
Elevated HDL (good) cholesterol: A HDL level above 70 mg/dL may cause your total cholesterol to be elevated. High HDL is considered protective against heart disease and is generally not a concern if your LDL and triglycerides levels are normal.
What to do if your total cholesterol level is 203?
Making changes to your diet and adopting healthy habits can help lower your total cholesterol level. To lower your cholesterol:
Eat fiber-rich foods such as veggies, fruit, whole grains, and legumes, daily for a total of 30-40g fiber/ day.
Limit sources of refined carbs and added sugars such as soda, chips, candy, baked goods, sweetened yogurt, and ice cream.
Avoid trans fats like partially hydrogenated oils and reduce your saturated fat intake to < 10% total calories.
Eat small, fatty fish like salmon, sardines, and trout, at least twice a week.
Be active every day: Aim for 30-60 minutes of physical activity 5x/week.
Incorporate plant sterols and stanols daily (2g) in the form of food or a supplement.
Lose weight if you are overweight or obese.
If you have diabetes, achieve and maintain good blood sugar control (HbA1c).
Medications and supplements used to improve total cholesterol results
If diet and lifestyle changes are not enough to lower your cholesterol, some medications and supplements can be helpful to get them into a safer range. Some common ones include:
Medications are typically prescribed if diet and lifestyle changes do not lower total cholesterol levels enough on their own. Some common cholesterol medications include:
Statins: Statins (including atorvastatin, simvastatin, and rosuvastatin) reduce cholesterol production in your liver. Because they typically need to be taken for life, statins are only prescribed if diet and lifestyle changes aren’t enough .
Ezetimibe can be helpful for those with familial hypercholesterolemia and who have side effects with statins.
Bile acid sequestrants: These medications block cholesterol-rich bile acid from being absorbed into the bloodstream and can be prescribed in place of or in addition to a statin.
PCSK9 inhibitors: This medicine is injected under your skin every 2 or 4 weeks and may be prescribed alongside a statin if you are at high risk of heart attack or stroke, or have familial hypercholesterolemia.
Lomitapide: Typically prescribed if you have familial hypercholesterolemia and requires liver enzyme monitoring as it can cause liver damage. Lomitapide is commonly also taken with vitamin E.
Plant sterols and stanols: Found in plant cell membranes, plant sterols and stanols (also called phytosterols) are similar in structure to cholesterol in the body and block dietary cholesterol from being absorbed. Phytosterols can be found in small quantities in vegetable oils, nuts, legumes, whole grains, fruits, and vegetables; however, the average daily intake (500 mg) is typically not enough to lower cholesterol. Studies show consuming 2000 mg (2g) of plant sterol and stanols daily from diet and supplements is effective for lowering total cholesterol . Plant sterol and stanol supplements taken before or with meals can help lower total cholesterol in parallel with other recommended diet and lifestyle changes .
Omega-3 (EPA & DHA): Omega-3 fatty acids (specifically EPA & DHA) can significantly reduce blood triglyceride levels . For cholesterol-lowering benefits, aim to consume 2,400-3,000 mg of omega-3 fats per day from your diet (salmon, mackerel, and trout are all good sources) and a quality fish oil supplement.
Beta-glucan: Beta-glucan is a form of soluble fiber that has been shown to help lower cholesterol levels. It’s found naturally in whole grains like barley, oats, rye, and wheat, mushrooms, and seaweed and is also available as a nutritional supplement. For cholesterol-lowering benefits, consume 3-7 g/day from your diet and a supplement.
Psyllium: Another type of soluble fiber made from the husk of psyllium seeds, psyllium is good for digestive health and regularity and can also help lower cholesterol. Psyllium supplements are sold in powder form and can help reduce lipid levels when taken daily at a dose of 8-12 g/day.
Alpha-lipoic acid: A potent antioxidant made in the body, alpha-lipoic acid is also found in foods including carrots, beets, spinach, broccoli, potatoes, and red meat. Research indicates that 600 mg/day of alpha-lipoic acid from your diet and a supplement may help lower total cholesterol and LDL (bad) cholesterol .
Turmeric: A spice commonly used to flavor and color curry dishes, turmeric may be helpful in lowering pro-inflammatory markers, blood cholesterol, and triglycerides . More research needs to be done to determine optimal form and dosage but supplementing with 500 mg/day appears to be safe and potentially beneficial for lowering cholesterol.
Bergamot extract: Bergamot is a citrus fruit that has long been used for medicinal purposes. Taking bergamot extract (made from the juice of the fruit) seems to lower cholesterol and triglyceride levels in adults with high cholesterol [10,11]. One study suggests taking bergamot extract daily for a month may be as effective as taking a low dose of the cholesterol-lowering drug called rosuvastatin (Crestor) . A recent research review indicates that 1000 mg/day may be most effective for lowering cholesterol.
Green tea extract: Made from the leaves of the Camellia sinensis plant, green tea extract is a natural supplement that has been shown to help lower LDL (bad) and total cholesterol . A daily dose of 400 mg may help lower your cholesterol but check with your doctor first as green tea extract can interact with certain medications, including beta-blockers and blood thinners. In addition, green tea extract may also have a stimulant effect.
High Cholesterol: Symptoms, Causes and Treatment
What is cholesterol?
Cholesterol is a waxy substance your liver makes to protect nerves and to make cell tissue and certain hormones. Your body also gets cholesterol from the food you eat. This includes eggs, meats, and dairy. There is “good” (HDL) cholesterol and “bad” (LDL) cholesterol. Too much bad cholesterol (LDL) can be bad for your health.
What is the difference between “good” cholesterol and “bad” cholesterol?
Good cholesterol is known as high-density lipoprotein (HDL). It removes cholesterol from the bloodstream. Low-density lipoprotein (LDL) is the “bad” cholesterol.
If your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. But, if your total cholesterol level is high only because of a high HDL level, you’re probably not at higher risk.
Triglycerides are another type of fat in your blood. When you eat more calories than your body can use, it turns the extra calories into triglycerides.
Changing your lifestyle (diet and exercise) can improve your cholesterol levels, lower LDL and triglycerides, and raise HDL.
Your ideal cholesterol level will depend on your risk for heart disease.
- Total cholesterol level – less than 200 is best, but it depends on your HDL and LDL levels.
- LDL cholesterol levels – less than 130 is best, but this depends on your risk for heart disease.
- HDL cholesterol levels – 60 or higher reduces your risk for heart disease.
- Triglycerides – less than 150 milligrams per deciliter (mg/dl) is best.
Symptoms of high cholesterol
Often, there are no specific symptoms of high cholesterol. You could have high cholesterol and not know it.
If you have high cholesterol, your body may store the extra cholesterol in your arteries. These are blood vessels that carry blood from your heart to the rest of your body. A buildup of cholesterol in your arteries is known as plaque. Over time, plaque can become hard and make your arteries narrow. Large deposits of plaque can completely block an artery. Cholesterol plaques can also break apart, leading to formation of a blood clot that blocks the flow of blood.
A blocked artery to the heart can cause a heart attack. A blocked artery to your brain can cause a stroke.
Many people don’t discover that they have high cholesterol until they suffer one of these life-threatening events. Some people find out through routine check-ups that include blood tests.
What causes high cholesterol?
Your liver produces cholesterol, but you also get cholesterol from food. Eating too many foods that are high in fat can increase your cholesterol level.
Being overweight and inactive also causes high cholesterol. If you are overweight, you most likely have a higher level of triglycerides. If you never exercise and aren’t active in general, it can lower your HDL (good cholesterol).
Your family history also affects your cholesterol level. Research has shown that high cholesterol tends to run in families. If you have an immediate family member who has it, you could have it, too.
Smoking also causes high cholesterol. It lowers your HDL (good cholesterol).
How is high cholesterol diagnosed?
You can’t tell if you have high cholesterol without having it checked. A simple blood test will reveal your cholesterol level.
Men 35 years of age and older and women 45 years of age and older should have their cholesterol checked. Men and women 20 years of age and older who have risk factors for heart disease should have their cholesterol checked. Teens may need to be checked if they are taking certain medicines or have a strong family history of high cholesterol. Ask your doctor how often you should have your cholesterol checked.
Risk factors for heart disease include:
- Cigarette smoking
- High blood pressure
- Older age
- Having an immediate family member (parent or sibling) who has had heart disease
- Being overweight or obese
Can high cholesterol be prevented or avoided?
Making healthy food choices and exercising are two ways to reduce your risk of developing high cholesterol.
Eat fewer foods with saturated fats (such as red meat and most dairy products). Choose healthier fats. This includes lean meats, avocados, nuts, and low-fat dairy items. Avoid foods that contain trans fat (such as fried and packaged foods). Look for foods that are rich in omega-3 fatty acids. These foods include salmon, herring, walnuts, and almonds. Some egg brands contain omega-3.
Exercise can be simple. Go for a walk. Take a yoga class. Ride your bike to work. You could even participate in a team sport. Aim to get 30 minutes of activity every day.
High cholesterol treatment
If you have high cholesterol, you may need to make some lifestyle changes. If you smoke, quit. Exercise regularly. If you’re overweight, losing just five to 10 pounds can improve your cholesterol levels and your risk for heart disease. Make sure to eat plenty of fruits, vegetables, whole grains, and fish.
Depending on your risk factors, your doctor may prescribe medicine and lifestyle changes.
Living with high cholesterol
If you have high cholesterol, you are twice as likely to develop heart disease. That is why it is important to have your cholesterol levels checked, especially if you have a family history of heart disease. Reducing your LDL “bad cholesterol” through good diet, exercise, and medicine can make a positive impact on your overall health.
Questions to ask your doctor
- Am I at risk for heart disease?
- How often should I get my cholesterol tested?
- What are my cholesterol levels? Are they high?
- What lifestyle changes do I need to make to help improve my cholesterol levels and heart health?
- Do I need cholesterol medicine?
- What are the side effects of the medicine?
Centers for Disease Control and Prevention: Cholesterol
National Institutes of Health, National Heart, Lung, and Blood Institute: Cholesterol
Tires and wheels for Mercedes C-Class (W203, CL203, S203), wheel size for Mercedes C-Class
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Wheel parameters for Mercedes C-Class
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203 mm howitzer B-4 model 1931. USSR
The development of a long-range 203-mm howitzer project was started at the Design Bureau of the GAU Artillery Committee in 1926 in accordance with the decision of the Revolutionary Military Council of the USSR on the re-equipment of large and special-capacity artillery with a new domestic materiel. It was planned to create a “triplex”: a 122-mm corps gun, a 152-mm artillery gun of the reserve of the main command (ARGC) and a 203-mm howitzer ARGC. These works were initially headed by the head of the Design Bureau Artkom GAU F.F. Lander, and then after his death, at 1927 year, the leading designers of the Leningrad plant “Bolshevik” were engaged in the creation of howitzers. The howitzer was developed in 1928 in two versions: with and without a muzzle brake. The barrels of the guns and ballistics in both versions were the same, but preference was given to the barrel without a muzzle brake. The working drawings of the oscillating part of the howitzer were created at the Artkom design bureau, and the working drawings of the tracked carriage were created at the design bureau of the Bolshevik plant.
The new gun received the B-4 index. His first prototype was made at the Bolshevik plant at 1931 years old. The features of this howitzer included the use of a caterpillar carriage. In those years, not a single wheel could withstand the force of recoil when firing from 203-mm guns with a full charge, so an original decision was made: to replace the wheel drive with a caterpillar one, which provided the howitzer with a sufficiently high maneuverability, allowing firing from the ground without the use of stops and arrangement special site. This technical feature allowed the carriage to become unified for a whole family of “triplex” heavy heavy guns of high power, consisting of 152-mm Br-2 guns, 203-mm B-4 howitzers and 280-mm Br-5 mortars. For transportation in the stowed position, the howitzer was disassembled into two parts: the barrel, removed from the carriage and laid on a special wagon, and separately, a caterpillar carriage connected to the limber.
Caterpillar tractors “Kommunar” were used for transportation, the highest permissible speed on the highway was 15 km/h. For short distances, the howitzer was allowed to be transported unassembled. A similar method of transportation could be used in the course of hostilities to advance howitzers for direct fire at the reinforced concrete defensive structures of the enemy. However, due to the large number of shortcomings, the design of the howitzer required significant changes, so already at 19In 32, it was modernized. On the same gun carriage, they put an elongated 3 caliber and more durable barrel. Howitzers with an old barrel were named “B-4 low power” (MM), and guns with a new barrel – “B-4 high power” (BM). After lengthy field and military tests, on June 10, 1934, the gun was adopted by the Red Army under the designation “203-mm howitzer of the 1931 model. ”
Howitzer B-4 had a bonded or monoblock barrel with a liner; piston type lock; hydraulic recoil brake; hydropneumatic knurler; variable rollback length; cartridge loading and a heavy caterpillar carriage.
To facilitate the loading of the howitzer, a manual winch was mounted on the carriage. As a light shield cover, the backs of the seats mounted on a gun carriage on both sides of the barrel were used. Ammunition B-4 consisted of shots of separate cartridge loading. Shooting was carried out with high-explosive and concrete-piercing shells. The firing range of a high-explosive projectile weighing 100 kg, with an initial speed of 575 m / s, was 18,000 m. A concrete-piercing projectile, with an initial speed of 600 m / s, pierced a concrete floor up to one meter thick. Thanks to the large elevation angle (up to 60 °) with a full and eleven different variable charges, giving different initial projectile velocities, it was possible to choose the optimal trajectories for hitting a variety of targets.
203-mm howitzer B-4 was designed to destroy especially strong concrete, reinforced concrete and armored structures of the enemy, to fight enemy artillery and to suppress distant targets, as well as to destroy targets located far from the front line. During the Soviet-Finnish war in 1939 – 1940, the Red Army for the first time on a massive scale used large-caliber artillery to break through the heavily fortified enemy defenses, including 203-mm howitzers of the 1931 model.
As of March 1, 1940, there were 142 B-4 howitzers on the Finnish front. On June 22, 1941, the Red Army already had 849 B-4 howitzers, which were in service with 33 high-capacity howitzer artillery regiments of the RVGK. Artillery of the RVGK was intended to reinforce artillery groupings in the main directions.
During the Great Patriotic War, 203 mm B-4 howitzers were successfully used, and thanks to their power, excellent ballistics of 12 variable charges and an elevation angle of 60 °, the choice of the optimal trajectory for hitting a variety of targets was ensured. The Headquarters of the Supreme High Command maneuvered these guns at the right moments, forming a huge qualitative and quantitative superiority over the enemy in the breakthrough areas. Howitzer artillery regiments of high power of the RVGK after the outbreak of war were withdrawn to the rear, and they took part in hostilities only from the end of 1942 years, when the strategic initiative began to gradually pass into the hands of the Red Army.
203-mm howitzer model 1931 was successfully used both in breaking through fortified areas and in storming fortresses, as well as in street battles in big cities. The howitzer was used in breaking through fortified lanes (“Mannerheim Line”, “Karelian Wall”, etc.), during the storming of fortresses (East Prussia), as well as in street battles in large cities (Berlin, etc.). 38 B-4 howitzers. Howitzer crews acted boldly, firing at close range at fortified pockets of resistance, destroying them and annihilating the defenders. So, one of the guns at the intersection of Lidenstrasse and Ritterstrasse, from a distance of 150 meters, with 6 shots destroyed a building well fortified and prepared for a long defense. By 1 May 1945 years of 203-mm B-4 howitzers were available in 30 howitzer artillery brigades and 4 separate high-capacity howitzer artillery regiments of the RVGK.
203 mm howitzer B-4 model 1931 was produced at the Bolshevik plant
(Leningrad) from 1932 to 1941, and at the Barricades plant (Stalingrad) from 1937 to 1941. However, the complete unification of the B-4 howitzers produced by the Bolshevik and Barrikady factories was not achieved. In 1938, a third plant, Novokramatorsky, was connected to their production. In total, 1008 B-4 howitzers were produced, of which 31 B-4MM howitzers and 977 B-4BM howitzers. After the end of the war, the B-4BM was upgraded again.
In 1954, the chief designer of the Barrikady plant, G.I. Sergeev put it on a two-axle wheeled carriage. The 203-mm howitzer with a new carriage received the B-4M index and was adopted by the Soviet Army in 1955.
Implement transportation has become inseparable, towing speed has increased significantly up to 35 km/h.