Medical questions & health advice by board certified doctors
"Should my good cholesterol be higher than my bad cholesterol?"
I just don't understand what ratio I am supposed to have. I've heard a lot of contradictory things.
Cholesterol is a confusing concept for many people and the goals for having good control continue to change. First, let me explain briefly what cholesterol is and why it’s important at all. Then I’ll talk a little about the different types of cholesterol and finally explain what the numbers ought to be. Cholesterol is one of the basic building blocks of cell membranes and is critical for constructing many hormones. Unfortunately, cholesterol has other roles that are more harmful. The reason that so many doctors care about it is because cholesterol is involved in plaques in arteries and the disease process that causes strokes and heart attacks. This is where good cholesterol and bad cholesterol come into play. First, let me say a little about the “good” form of cholesterol, known as high-density lipoprotein (HDL) cholesterol. HDL works in a number of ways, but importantly it helps transport other cholesterol particles from tissues and blood back to the liver, including by helping to remove bad or low-density liopoprotein (LDL) cholesterol from plaques in arteries. High concentrations of LDL cholesterol are associated with plaque formation in the arteries, and it is these plaques that can narrow arteries or rupture and cause heart attacks and strokes. The levels of cholesterol are usually measured in total cholesterol, LDL, HDL, and triglycerides. The ratio is calculated by dividing the level of LDL cholesterol by the level of HDL cholesterol. For instance if your LDL was 250 and your HDL was 50 the ratio would be 5:1. A good ratio is 4:1 or lower, but doctors more commonly target individual levels of LDL and HDL. These target levels can vary based on your other medical problems or history and your primary care physician or cardiologist can best discuss your results to help you meet your goals. Good luck!
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