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Ask A Doctor... About Cholesterol

September 16, 2016 | By Lisa Schwenk
Published in: Heart, Question Answer

cholesterol lab report

Ask the Doctor: What's the difference between 'good' cholesterol, 'bad' cholesterol, and triglycerides? Aren't they all just fat in your blood that causes heart attacks?

Dave Varma, MD
Dave Varma, MD

Answer provided by Dave Varma, MD, a cardiologist with Augusta Health Cardiology in the Heart & Vascular Center at Augusta Health.

Dr. Varma attended the University of Maryland School of Medicine, then completed his residency and fellowship at the University of Virginia. He also earned a Masters in Public Health from Johnson Hopkins University. His professional interests are complete cardiovascular care: nuclear cardiology, consultation, echocardiography, invasive cardiology and peripheral vascular disease assessment. Dr. Varma is married and has two sons; he enjoys tennis, movies and watching college sports.

While both high blood cholesterol and a high level of triglycerides can increase your risk of heart attack, there is a difference between cholesterol and triglycerides.

Cholesterol is a waxy, fat-like substance. Your body actually needs cholesterol, but when it builds up on the walls of your arteries, it can lead to heart attack or stroke. There are two types of cholesterol that are sometimes called 'good' cholesterol and 'bad' cholesterol.

HDL Cholesterol, or high density lipoprotein cholesterol, is the 'good' cholesterol because it absorbs cholesterol and carries it to the liver so it can exit the body. High levels of HDL cholesterol can actually reduce the risk of heart attack and stroke.

LDL Cholesterol, or low density lipoprotein cholesterol, is the 'bad' cholesterol that can build up in your arteries and increase the risk of heart attack and stroke. Unfortunately, most of your body's cholesterol is LDL cholesterol.

Triglycerides really are a type of fat found in your blood that your body uses for energy.

Your total cholesterol is based on your HDL, LDL and triglyceride levels. They are all important to your heart health.

We measure your cholesterol levels by running a blood test that is sometimes called a lipid panel or lipid profile. This test is usually run first thing in the morning because you have to fast nine to 12 hours before the blood draw for accurate measurement. Cholesterol should be checked regularly, just like blood pressure—although not quite as frequently. You should start getting your cholesterol checked when you are 20 years old, and have it checked every five years as long as it is normal. If it is not normal, it should be checked more frequently.

We are looking for these levels:
  • Total Cholesterol Less than 200 mg/dL
  • LDL (bad) Cholesterol Less than 100 mg/dL
  • HDL (good) Cholesterol 60 mg/dL or higher
  • Triglycerides Less than 150 mg/dL

If your numbers are too high, healthy lifestyle choices will help lower them. These choices include exercising, eating a healthy diet, and not smoking. Lowering your cholesterol can reduce your risk of having a heart attack, needing angioplasty (balloon surgery) or heart bypass surgery or perhaps even dying of heart disease.