Do you know your lipid numbers? Here’s why you should
Cholesterol has a bad rap, even though it’s a necessary component for making all of the body’s cell walls. But too much of a good thing can be a bad thing, and that’s where lipid panels, also known as cholesterol tests, come in.
“We check lipid panels because heart disease is so prevalent, and we want to identify people who are at risk for cardiovascular disease and help them decrease that risk,” said Heather Malcomson, NP, an advanced practice nurse practitioner with Cape Cod Healthcare who is based at Strawberry Hill Primary Care in Hyannis. “Lipid testing is a quick and reliable way to screen and identify patients who are at risk.”
Lipid panels are commonly ordered by primary care providers, she said. The lipid panel is a blood test that consists of four measures: total cholesterol, triglycerides, LDL or low-density lipoproteins, and HDL or high-density lipoprotein.
Here’s what a lipid panel’s numbers tell your care provider. The optimal levels are measured in milligrams per deciliter of blood (mg/dL)
LDL or low-density lipoproteins – “The LDL is sometimes known as the bad cholesterol,” Malcomson said. “It can build up on the walls of your blood vessels and cause plaques. When plaques build up, the arteries can become narrower over time, or that plaque becomes unstable and can rupture, causing stroke or a heart attack. The goal for a bad cholesterol is ideally less than 100. If someone is at high risk, meaning that we know that they have cardiovascular disease, they’ve had a stroke in the past, or they have diabetes, the goal is less than 70.”
HDL or high-density lipoproteins – “HDL is often called the good cholesterol, because it absorbs cholesterol in the blood and carries it back to the liver, which then flushes it from the body,” she said. “So, high HDL cholesterol helps lower your risk of coronary artery disease. For men, it should be at least 45 and for women it should be at least 55.”
Total cholesterol – “This is the sum of HDL, LDL cholesterol, and 20 percent of triglycerides. The goal is less than 200,” she said.
Triglycerides – “Triglycerides are a type of fat that circulates in your blood. High triglycerides can increase your risk of atherosclerosis – hardening of the arteries or thickening of the artery walls – which will increase your risk of heart attack, stroke and heart disease. We also see that sometimes high triglycerides can cause acute inflammation, including pancreatitis. That goal is less than 150,” she said.
Treating Each Patient Holistically
The National Heart, Blood and Lung Institute recommends initial cholesterol testing between ages of 9 and 11 and every five years after that until age 40, when people should be tested annually.
“Triglycerides are very diet-dependent, so we encourage fasting eight to 12 hours before your blood is checked, to be sure the test is accurate,” she said.
If the results of your lipid panel are less than optimal, there are steps you can take. Medication may be warranted, but lifestyle changes can make a big difference, said Malcomson.
“My big passion is treating each patient holistically,” she said. “A healthy lifestyle is the cornerstone of general well-being of the mind and body, including a whole-grain, plant-based diet, daily exercise, limiting alcohol and not smoking. We know that there are lipid-lowering benefits to a healthy lifestyle that decrease cardiovascular disease.
“Cardiovascular disease is influenced by age, gender, comorbidities and family history. The more we know, and lipid panels are an important part of that, the better we can work on shared decision-making for steps that will lower your risk.”
