How Important Are Blood Lipids in Determining the Risk of Heart Disease and Stroke

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LDLs are a major player in the development of atherosclerosis. Because elevations in LDL-cholesterol are associated with increased risk of heart disease and stroke, it is often deemed the "bad cholesterol." Although it may not be this simple, higher LDL-cholesterol levels means that there are more LDLs in the blood, which in turn means more LDLs that can participate in atherosclerosis.

On the other hand, HDL-cholesterol seems to decreases the risk of heart disease and it is often referred to as the "good cholesterol." Researchers believe that the virtuous nature of HDLs is due to their ability to gather some of the cholesterol associated with atherosclerotic plaque. This could slow the progression of atherosclerosis. In addition, HDLs carry antioxidants which can reduce LDL oxidation.

Higher levels of LDL cholesterol are linked to greater risk of heart disease.

What Are Recommendations for Blood Lipids?

A blood lipid profile can help to assess an individual's risk. Among the several telling indicators are elevated total and LDL-cholesterol levels, reduced HDL-cholesterol levels, and elevated ratios of total cholesterol to HDL-cholesterol and LDL-cholesterol to HDL-cholesterol levels. However the American Heart Association suggests that physicians and individuals pay closer attention to the individual measurements versus the ratios. Table 13.2 provides the association's goals for blood cholesterol and triglyceride levels.

What Factors Raise Total and LDL Cholesterol?

LDL is called bad cholesterol because as its level increases in the blood, so does the risk of heart disease. As mentioned above, the more LDL in the blood, the more LDL can move into the artery walls and participate in atherosclerosis. The primary factors that seem to raise total and LDL cholesterol levels are:

  • smoking
  • inactive lifestyle
  • obesity
  • high saturated fat intake

Table 13.2 Standard Levels for Blood Lipids and Cardiovascular Risk

Classification and Consideration

Total Cholesterol <200

Considered a desirable level for total cholesterol This is a borderline high level

This is high total cholesterol as it is associated with more than two times greater risk of developing coronary heart disease compared with a total cholesterol is less than 200 milligrams per deciliter.

LDL Cholesterol <100

100 to 129

Considered a very desirable level for LDL cholesterol This is a desirable level for LDL cholesterol to borderline high level

Considered a borderline high LDL cholesterol level High LDL cholesterol level Very high LDL cholesterol

130 to 159 160 to 189 > 190

HDL Cholesterol <40 (men) and <50 (women) >60 mg/ 100 ml Triglycerides

This is a desirable level for HDL cholesterol

Considered low HDL cholesterol


150 to 200 >200

Considered a very desirable level for triglycerides This is borderline high triglycerides level Considered high triglycerides level

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