Why Are There So Many Cholesterol Numbers And What Do They Mean?

— -- Question: Why are there so many cholesterol numbers and what do they mean?

Answer: The American Heart Association has set guidelines specifically for women about what normal cholesterol levels are. Those include the total cholesterol number, which we recommend should be less than 200.

The LDL cholesterol, which is known as the bad cholesterol -- and one way to remember that is: 'L' is for 'lousy,' we want it 'lower.' And the optimal number that we like to see is an LDL cholesterol of less than 100.

There's another important cholesterol number that we should all know, which is the HDL cholesterol, also known as the 'good' cholesterol. And the way we can remember that is: 'H' is for 'healthy' and we want it 'higher.' Now the magic number for women is actually different than for men. In men, we consider an HDL, or good cholesterol, less than 40 to be an elevated risk factor for heart disease. If that number is less than 50 in a woman, then that's considered an important risk factor. So we like to see the HDL cholesterol numbers above 50, and actually, if we can get them above 60 that's even better. That's considered protective for the heart, when we increase our HDL or good cholesterol.

There's another cholesterol fraction that many people are not familiar with. So we've talked about the good, the bad, and now we'll talk about the ugly. Triglycerides is another important cholesterol number that we need to be aware of, and the magic number for this is less than 150.

Now, sometimes you'll see on your cholesterol output that there's something called a ratio -- this is the ratio of the total cholesterol to the good cholesterol. And this can be an important indicator of risk in women. We like this number less than five, but getting it even lower is better.

One thing that we should know, though, is that we have not set our guidelines around this ratio. So for most healthcare providers, we're going to focus on your individual number, so what we want you to learn about and know what your numbers are, is: your total cholesterol, your good cholesterol, your bad cholesterol, and your triglycerides. But I will say that the total cholesterol in women is not very predictive of developing heart disease, and the reason for that is the total cholesterol can contain a good amount of good cholesterol. And so it can sometimes be misleading; so don't settle just knowing what your total cholesterol number is -- be sure that you learn about the individual cholesterol numbers, especially the LDL, the HDL, and the triglycerides.

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