Question: I have heard all there is about good and bad cholesterol. I have also heard that the readings between LDL and HDL don't mean as much as the ratio between the two. What do I need to know to keep my heart healthy?
Dr. Hibberd’s answer:
You need to keep the LDL "bad" cholesterol under 100, if you are healthy. If you have heart disease, diabetes or a strong family history of coronary artery disease, you need to keep your LDL under 80. This almost always requires prescription medicine to achieve.
HDL "good" cholesterol should be as high as possible. It mops up the cholesterol fragments that would otherwise deposit in your artery walls. HDL readings of 40 or less can put you at increased risk for heart disease. Try to keep HDL over 60.
Some people, especially women, have HDL readings of over 100. I personally don’t bother with ratios, as these are independent risks, and ratios confuse many patients, mainly because differing ratios are often used in reporting. It is far easier to interpret each risk independently, bearing in mind that a 10-point elevation in HDL reduces vascular and heart risk roughly equal to a 40 point reduction in LDL.
If you insist on using the LDL/HDL ratio, you want that ratio to be under five for reduced risk, and ideally as close to two as possible
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