Knowing your cholesterol level can be a crucial factor in overall health


On a top 10 list of things to do, checking your cholesterol level probably doesn’t make the cut — but no matter what your age, knowing your numbers can be a crucial factor in overall health .

People in their 20s may never consider checking their cholesterol, but they should because it can uncover a genetic predisposition to high cholesterol that they didn’t know about. The sooner it is treated, the more damage you can prevent.”

Dr. Michael Farbaniec, cardiologist, Penn State Health Milton S. Hershey Medical Center

In fact, the National Heart, Blood and Lung Institute recommends initial testing between ages 9 and 11 and every five years thereafter.

People over 40 should get a lipid panel annually, and they should ask to have it added to annual blood work if their primary care physician doesn’t order it—as it’s easily overlooked with the plethora of other problems that are maintained, said Farbaniec.

What is a healthy level of cholesterol?

Cholesterol, a waxy substance made in the liver and found in the blood and all the body’s cells, is needed for making cell walls, creating hormones, acting as protective agents for cells and more. In order to get energy for muscles and cells, cholesterol is transported in the low-density lipoprotein (LDL), commonly called “bad cholesterol,” and the high-density lipoprotein (HDL), or “good cholesterol.”

In addition to total cholesterol, a lipid panel measures these lipoproteins as well as triglycerides, fatty acids in the blood that the body uses for energy. Directly affected by exercise and diet, high levels of triglycerides combined with low HDL cholesterol or high LDL cholesterol levels can increase your risk for plaque buildup, fatty liver disease, heart attack, and stroke.

Although many people can quote their total cholesterol number and be happy if it is below the recommended threshold of 200 mg/dL, it seems that the most important value to know is what is called non-HDL cholesterol. This number is arrived at by subtracting your HDL from your total cholesterol.

“We shifted our thinking away from that total value because we know we underestimated people’s risk, and they were dying of heart disease,” Farbaniec said. “If your total cholesterol is under 200, but your HDL is 25 and your LDL is 170, that’s not good.”

Deal with the risk, not the numbers

Ideally, non-HDL cholesterol would be less than 130 mg/dL for people without risk factors. For those at increased risk for heart disease due to a family or personal history of cardiovascular disease, other health problems or those with familial hypercholesterolemia – inherited high cholesterol that is not affected by a change in diet or exercise – the LDL- value less than 70 mg/dL, Farbaniec said. Triglyceride levels should be less than 150 mg/dL. A value above 200 is considered high.

That said, it’s important to consider risk factors for cardiovascular disease on an individual basis rather than relying on the numbers.

“I had a patient with normal cholesterol, but she had a family history of heart disease at a very early age, and she was very concerned,” Farbaniec said. “I did a coronary artery calcium scan, and it showed a lot of calcified plaque build-up. That told me she’s someone at risk, despite her good numbers, but we can do something now to prevent more plaque build-up.”

Others at risk for high cholesterol are those with high blood pressure, obesity, diabetes, premature heart disease, vascular disease and familial hypercholesterolemia, he said. Certain medications can also cause levels to rise.

The American College of Cardiology offers a risk calculator where users can enter factors such as age, lipid values ​​and other factors to estimate the risk of atherosclerotic cardiovascular disease.

Take the first step

Getting a lipid panel done is not difficult. All it requires is a lab order from your doctor.

Nowadays, most doctors do not require fasting for routine screening because the non-HDL cholesterol levels are not changed by fasting. Some patients, especially those already under treatment, may still wonder how long to fast for a lipid panel and the answer is about 10 hours, Farbaniec said.

Statins, prescription drugs used to lower cholesterol levels, are the mainstay treatment for high cholesterol, but there are many other options, Farbaniec said.

“The most important thing is to get a lipid panel done,” he said. “No one can feel if they have high cholesterol, but the results of a test can help us treat preventively for a healthier future.”

Studies have shown that statins can also shrink or stabilize plaque buildup, providing another reason why knowing the status of your cholesterol is important for overall health.


Penn State Health Milton S. Hershey Medical Center