In order to correctly estimate the patient's cardiovascular risk, in addition to the total amount of cholesterol in the blood, it is important to know its fractions: HDL - commonly referred to as good cholesterol - and LDL or bad cholesterol.
These consist of a lipid heart - rich in cholesterol and other fat-soluble substances - enclosed by a protein and phospholipid shell.
Due to their particular composition, these molecules are called plasma lipoproteins.
Lipoproteins are classified on the basis of density, which decreases as the lipid content increases and vice versa. In particular, lipoproteins with density are distinguished:
- Very low (VLDL);
- Low (LDL);
- Intermediate (IDL);
- High (HDL).
LDLs transport cholesterol from the liver to the periphery, thus promoting its deposit on the walls of the main arterial vessels.
HDLs, on the other hand, carry cholesterol from the periphery of the body to the liver, acting as a sort of scavenger capable of clearing the arteries of cholesterol deposits.
It is therefore not surprising that epidemiological studies have repeatedly shown that LDL cholesterol levels are positively correlated with cardiovascular disease (the higher their level, the greater the risk), while for HDL cholesterol there is a negative correlation (greater is the good cholesterol level, the lower the cardiovascular risk).
- Total cholesterol expresses the total amount of cholesterol contained in the various lipoproteins (LDL + VLDL + HDL). A value below 200 mg / dl of blood is considered normal.
- In addition to total cholesterol, it is also important to measure the amount of the two main types of cholesterol, namely the LDL and HDL fractions.
- The ideal HDL value is equal to or greater than 50 mg / dl of blood: the more there is in circulation, the more the risk of circulatory disorders is reduced.
- The relationship between the value of total cholesterol and that of HDL indicates, then, the risk of cardiovascular events that a person runs. The number obtained should be:
- less than 5 for men and 4.5 for women.
Often, hypercholesterolemia does not cause symptoms, as does arterial hypertension (eg headache and dizziness), and it is not even as visible as being overweight.
For this, it is necessary to periodically check the quantities:
- Adults should have their cholesterol levels measured every five years or more frequently if they have one or more risk factors for cardiovascular disease.
- Children and teens should be tested, however, between the ages of 9-11 and 17-21 years.
Prolonged use of some drugs can also contribute to the increase in cholesterolemia. From this point of view, the drugs most at risk are:
- Immunosuppressants;
- Antiretrovirals;
- Aromatase inhibitors;
- Cortisones;
- Oral contraceptives;
- Anabolic steroids.
There is also a particular form of hypercholesterolemia, called hereditary or familial, which is associated with a series of mutations in the LDL receptor gene, which is found on chromosome 19.
Cholesterolemia can be influenced by lifestyle. In particular, an improper diet can increase LDL cholesterol levels, while a sedentary lifestyle helps keep HDL levels low.
An important role is also played by smoking, which reduces the anti-sclerotic action of HDL cholesterol.
suddenly takes over, you have to be careful.The condition could indicate, in fact, the presence of:
- Disorders of the liver;
- Malabsorption syndromes;
- Malnutrition;
- Anemia;
- Hyperthyroidism.
On the other hand, the pharmacological reduction of cholesterol has no proven harmful effect.
During childhood, hypocholesterolemia is a more alarming situation. During growth, in fact, cholesterol is essential for building the membranes of the central nervous system and other organs. For this reason, if cholesterol is not present in sufficient quantities, problems can arise. In particular, there are genetic diseases (hypobetalipoproteinemias) in which LDL cholesterolemia is almost undetectable and is associated with mental retardation, neurological deficits, hepatosteatosis and other complications.
of 9-12 hours, during which it is only allowed to drink water. In the days preceding the blood sampling, it is important to follow your usual lifestyle and not to vary the diet in order to obtain objective parameters.
cardio-vascular, in fact, does not depend solely on cholesterolemia.
However, if the cholesterol values are not optimal, it is necessary to understand the reason for the increase. In all cases, to lower the hypercholesterolemia it is necessary to intervene on the underlying causes; in this regard, the doctor will be able to indicate the most appropriate strategies to deal with the situation.
An increase in total blood cholesterol can be due to genetic reasons, liver or kidney disorders, alcoholism, diabetes, certain medications (such as certain antibiotics, androgens, and steroids), and pregnancy. Those who eat a diet rich in animal protein and fat can also have high blood cholesterol levels.
Total cholesterol alone is poorly predictive of cardiovascular risk; a condition in which the total cholesterol is normal but the HDL fraction is particularly low is much more dangerous than a condition in which the total cholesterolemia exceeds the limit value of 200 mg / dL but the HDL fraction is higher in percentage.
The cardiovascular risk increases strongly for particularly high cholesterol levels (> 250 mg / dL).
Total cholesterol and cardiovascular risk
mg / dL
mmol / L
Interpretation
<200
<5,2
Desirable values
200 - 239
5,2 - 6,2
Total cholesterol close to the limit values that delineate the excess
> 240
>6,2
Excessive values
LDL cholesterolemia and cardiovascular risk
mg / dL
mmol / L
Interpretation
<70
<1,8
Optimal values for people with high cardiovascular risk
<100
<2,6
Optimal values for people with medium cardiovascular risk
100 - 129
2,6 - 3,3
Optimal LDL cholesterol for healthy people
130 - 159
3,3 - 4,1
LDL cholesterolemia close to the limit values that delineate the excess
160 - 189
4,1 - 4,9
Elevated LDL cholesterol
>190
>4,9
Very high LDL cholesterol
HDL cholesterolemia and cardiovascular risk
mg / dL
mmol / L
Interpretation
<40 if man
<50 if woman
<1,03
Low HDL cholesterol, increased cardiovascular risk
40-59
1,03-1,55
Normal HDL cholesterol
>60
>1,55
High HDL cholesterol, an optimal condition that protects against cardiovascular risk
Triglyceridemia and cardiovascular risk
mg / dL
mmol / L
Interpretation
< 150
<1,7
Desirable values
150-199
1,7-2,2
Triglyceridemia close to the limit values that delineate the excess
200-499
2,3-5,6
Elevated triglyceridemia
>500
>5,6
Very high triglyceridemia
In general, the LDL / HDL ratio (obtained by dividing the first by the second) should be less than three. Similarly, the ratio of total cholesterol to HDL cholesterol should be less than 5 in men and 4.4 in women.
People who, for example, have survived a heart attack, as well as diabetics and people who have at least two of the following risk factors are considered to be at high cardiovascular risk:
- Smoke;
- Hypertension;
- Family history of cardiovascular disease;
- HDL hypocholesterolemia;
- Age over 45 if a man or 55 if a woman.
About 80-90% of total cholesterol is produced autonomously by our body, especially by the liver, but also by the adrenal glands and the sex glands; the remaining percentage is covered by food.
Other articles on "Total Cholesterol - Hypercholesterolemia"
- Cholesterolemia - Hypercholesterolemia
- High cholesterol causes - hypercholesterolemia
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