Cholesterol, what are the optimal values?

Maintaining cholesterol within optimal levels protects the health of the heart and arteries. Here are the expert recommendations.

In reality, this substance is essential for the body, which needs it within certain limits—for example, to build cell membranes and to synthesize important molecules such as some hormones and vitamin D. Moreover, not all cholesterol circulating in the blood is equally harmful; in fact, there is even a type that should not fall below a minimum threshold.

Let’s see which types of cholesterol should be considered and what their optimal values are.

Cholesterol: total, LDL, and HDL

The three cholesterol values to consider are total cholesterol, LDL cholesterol (also known as “bad” cholesterol) and HDL cholesterol (also called “good” cholesterol). As its name suggests, total cholesterol indicates how much cholesterol is present in the blood regardless of the type.

When the goal is primary prevention in adulthood (i.e., for healthy people wanting to avoid disease onset), levels below 200 mg/dL are considered “desirable.” Total cholesterol levels between 200 and 239 mg/dL are considered “borderline high,” and levels from 240 mg/dL upward are considered “high cholesterol.”

Regarding LDL cholesterol for primary prevention in adults, it is considered:

• optimal if below 100 mg/dL;
• near optimal if between 100 and 129 mg/dL;
• borderline high if between 130 and 159 mg/dL;
• high if between 160 and 189 mg/dL;
• very high at 190 mg/dL and above.

For HDL cholesterol, a distinction is necessary between men and women: levels associated with low cardiovascular risk are above 40 mg/dL for men and above 48 mg/dL for women.

Personalized goals

When the heart and arteries are already exposed to risks, optimal cholesterol levels can change. In particular, the most recent recommendations on LDL cholesterol control vary according to cardiovascular risk and can be summarized as follows:

• In people with low or moderate cardiovascular risk, LDL cholesterol should be kept below 115 mg/dL;
• In people with high cardiovascular risk, LDL should be reduced below 100 mg/dL, or, if initial values are between 100 and 200 mg/dL, a reduction of at least 50% is recommended;
• In people with very high cardiovascular risk, LDL cholesterol should be reduced below 70 mg/dL, or, if initial values are between 70 and 135 mg/dL, a reduction of at least 50% is recommended.

How to bring cholesterol back to normal levels

Depending on the individual condition, medication may be necessary to bring cholesterol back to normal levels; it will be up to the doctor to decide if this is appropriate. However, a healthy lifestyle based on a balanced diet, regular physical activity, and abstaining from smoking is always essential. In addition to helping bring or maintain cholesterol within optimal levels, such a lifestyle helps control other cardiovascular risk factors, particularly body weight, blood sugar, blood pressure, and levels of blood triglycerides.

The latter can also be controlled with fish oil supplements rich in Omega 3, such as Omegor products; discover their benefits with our pharmacist!

Sources:

Catapano AL et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias: The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) Developed with the special contribution of the European Assocciation for Cardiovascular Prevention & Rehabilitation (EACPR). Atherosclerosis. 2016 Oct;253:281-344. doi: 10.1016/j.atherosclerosis.2016.08.018. Ministero della Salute. Dipartimento della prevenzione e della comunicazione. Direzione generale della sanità veterinaria e degli alimenti. Ufficio XII. Linee guida per la prevenzione dell'aterosclerosi. Documento approvato dalla Commissione Consultiva per i prodotti destinati ad un’alimentazione particolare. Settembre 2004. https://goo.gl/RKw6Mz Piepoli MF et al. Linee guida europee 2016 sulla prevenzione delle malattie cardiovascolari nella pratica clinica. G Ital Cardiol 2017;18(7-8):547-612. doi: 10.1714/2729.27821