Blood cholesterol abnormalities are a major risk factor for cardiovascular disease. A risk factor is a condition that increases your chance of getting a disease. Therefore, the higher your total cholesterol, the greater your risk for developing a form of cardiovascular disease (most commonly, heart attack or stroke). Heart disease is the number one killer of women and men in the United States. Each year, more than a million Americans have heart attacks, and about a half million people die from heart disease.
Total Cholesterol is found in all foods of animal origin and is part of every animal cell. It is used to make essential body substances such as cell walls and hormones, as well as for various other functions. Even if cholesterol is not consumed in the diet, the liver will manufacture enough to supply the body’s needs. In fact, approximately 20-30% of your cholesterol is manufactured by the liver, with the contribution influenced by inherited traits. In order to carry cholesterol and fat in the blood, the body wraps them in protein packages, called lipoproteins. Cholesterol is most commonly discussed as low-density lipoproteins (LDL) and the high-density lipoproteins (HDL), but exists in other forms such as very low-density lipoproteins (VLDL) and intermediate density lipoproteins (IDL).
HDL-cholesterol is your “good” cholesterol. Higher levels are more desirable, because HDL-cholesterol serves to transport cholesterol out of the system. This removal mechanism appears to play a protective role by carrying cholesterol away from the arterial walls to the liver, where it is then metabolized. High levels of HDL-cholesterol (see recommendation above) have been shown to dramatically reduce the risk for cardiovascular disease.
Cholesterol/HDL Ratio compares the ratio of Total Cholesterol to HDL-cholesterol. This value has more predictive power than the two measures alone and has been clinically shown to be one of the best predictors for future coronary risk. The evolving Framingham Heart Study, begun in 1948, has shown an average risk for vascular disease with ratios of 4.4 and 5.0 for women and men, respectively. Ratios of 3.1 and 3.4 reduce heart disease risk to approximately one half of the average.
Non-HDL-cholesterol is the sum of all “bad” forms of cholesterol – including LDL, IDL and VLDL fractions. Recommended levels for average risk individuals should be kept under 150 mg/dl. However, in the presence of additional risk factors, lower values are recommended. Note that the Non-HDL value is not the same as the LDL-cholesterol measure alone. The Non-HDL-cholesterol value is calculated by subtracting the HDL value from the total cholesterol. Another representation of Non-HDL-cholesterol is the sum of the LDL-cholesterol plus the triglycerides/5.
Glucose is a measure of the concentration of sugar in the blood and is the screening test for diabetes. Diabetes is a serious metabolic disease on its own, as well as an independent contributor to the risk of cardiovascular disease. Fasting glucose levels should be maintained between 70-99 mg/dl. Pre-diabetes is defined as a fasting glucose result between 100-125 mg/dl and diabetes is defined by values of 126 mg/dl or higher. Glucose is a dynamic result and repeat testing is required to confirm any diagnosis. Testing non-fasting glucose levels has been clinically shown to predict the future risk of developing diabetes. Non-fasting glucose levels, as defined as less than two hours after eating, should not exceed 140 mg/dl.
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