Know your cholesterol numbers

Kenneth Bescak, M.D., Cardiologist; Lipidologist Sept. 14, 2010

Measuring Cholesterol Levels

According to the American Heart Association, Coronary Artery Disease (CAD) is the No. 1 killer in the U.S. Although the death rate over the last 20 years has decreased, the prevalence has increased. A major risk factor for developing CAD is unhealthy lipid levels, more commonly known as cholesterol, in the blood.

Hyperlipidemia is the general term applied to high blood cholesterol and/or elevated blood triglycerides.

Good and Bad Cholesterol
There are two major types of lipids/cholesterol:
• LDL or low density (especially small particle) lipoproteins, commonly referred to as “bad” cholesterol
• HDL or high density (larger particle) lipoproteins, commonly referred to as “good” cholesterol

Decreasing LDL levels and increasing HDL levels are the primary targets for lipid management in the treatment of CAD. Although some people have a genetic predisposition for high triglycerides and low HDL, most unhealthy levels are due to poor lifestyle choices including lack of exercise, high calorie diets and excess consumption of saturated fats and refined sugars. Because of these choices, over the last 20 years there has been an epidemic in obesity, hypertension, diabetes and pre-diabetes, and the numbers are expected to double over the next 20 years.

Monitoring HDL and LDL Levels 
Normal levels are not represented by a single number; rather, they should ideally fall somewhere in a range of normal values. These ranges change with age. For instance, a 25 year old with an LDL of 160 mg/dL is vastly different from a healthy 75 year old with an LDL above 160 mg/dL. The 25 year old would be at risk for cardiovascular disease, especially if a genetic predisposition exists.

Guidelines published by both the American Heart Association and the National Cholesterol Education Program specify these measures (mg/dL):

Total Cholesterol Level                    
Desirable: less than 200
Borderline high: 200 to 239
High: greater than 240
LDL Cholesterol Level
Optimal: less than 100
Near/above optimal: 100 to 129
Borderline high: 130 to 159
High: 160 to 189
Very high: greater than 190
HDL Cholesterol Level 
Men – Low: less than 40
Women – Low: less than 50
High: greater than 60
Ideal: less than 100

Triglyceride Levels
Normal: 100 to 150
Borderline high: 150 to 200
High: 200 to 500
Very high: 500 to 1,000
Extreme: greater than 1,000
Treatment Options
The general recommendation is that people over the age of 20 should have their cholesterol measured once every five years. The best method of measuring cholesterol levels is with a blood test called a lipid panel or lipid profile. Because cholesterol and triglyceride levels rise after a meal – particularly one high in fat, sugars or alcohol – patients may be asked to fast 12 to 14 hours prior to having blood drawn.

When considering treatment options, all these numbers must be considered. Diet has little effect on total the LDL levels. On the other hand, triglycerides are diet and exercise sensitive. Diets low in saturated fats and refined sugars and high in Omega 3 fish oil can lower triglycerides. Additionally, exercise needs to be aerobic for at least one hour each day at least five days per week; red wine in moderation by some persons also can be effective in raising HDL levels.
About Dr. Bescak
Kenneth J. Bescak, M.D., F.A.C.C., diagnostic cardiologist at the Heart & Vascular Center of Northern Arizona, is the only board-certified lipidologist north of Phoenix. He is one of only eight certified lipidologists in Arizona. As a lipidologist, Dr. Bescak focuses on lipid and lipoprotein metabolism and its associated disorders. He specializes in the diagnosis and treatment of cholesterol disorders, which cause atherosclerosis and cardiovascular disease. Approximately one-third of all deaths in the U.S. are attributed to these health concerns.

To schedule an appointment with Dr. Bescak or any of the cardiovascular physicians at the Heart & Vascular Center of Northern Arizona, call 977 928-WELL. For more information, visit

A partnership between Flagstaff Medical Center (FMC) and Verde Valley Medical Center (VVMC), the Heart & Vascular Center offers a wide spectrum of care. Diagnostic services available through the program’s affiliation with FMC and VVMC include stress testing, nuclear imaging, cardiac and peripheral ultrasound, cardiac Doppler and pacemaker/defibrillator interrogation and programming. When intervention procedures are necessary, cardiac catheterization, balloon angioplasty, stent placement, permanent pacemaker insertion and treatment for peripheral arterial disease are available (including aortic endograft therapy and carotid stenting).