From the Guidelines
Total cholesterol should be less than 200 mg/dL to minimize the risk of heart disease and stroke. Total cholesterol is a measurement of all cholesterol types in your blood, including low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides. It's an important health indicator that helps assess your risk for heart disease and stroke.
- A healthy total cholesterol level is generally below 200 mg/dL,
- levels between 200-239 mg/dL are considered borderline high,
- and levels at or above 240 mg/dL are high. Regular cholesterol screening is recommended for adults, typically starting at age 20 and repeating every 4-6 years for those at average risk. If your total cholesterol is elevated, lifestyle modifications like eating a heart-healthy diet low in saturated fats, regular exercise, maintaining a healthy weight, and avoiding tobacco can help lower it, as supported by studies such as 1. In some cases, medications such as statins (like atorvastatin or rosuvastatin) may be prescribed if lifestyle changes aren't sufficient, with the goal of reducing total cholesterol to less than 200 mg/dL, as recommended by guidelines such as 1 and 1. Cholesterol management is important because excess cholesterol can build up in artery walls, forming plaques that restrict blood flow and increase the risk of cardiovascular events.
The most recent and highest quality study, 1, highlights the importance of regular exercise and a healthy diet in managing cholesterol levels, and reducing the risk of heart disease and stroke.
- Regular physical activity has been shown to improve HDL cholesterol levels and reduce triglycerides,
- while a diet low in saturated fats can help lower LDL cholesterol. By maintaining a healthy lifestyle and managing cholesterol levels, individuals can reduce their risk of cardiovascular disease and improve their overall health, as supported by studies such as 1 and guidelines such as 1 and 1.
From the FDA Drug Label
For individuals with TG less than 400 mg/dL (<4. 5 mmol/L), LDL-C can be estimated using the following equation: LDL-C = Total cholesterol - [(TG/5) + HDL-C] Prior to initiating therapy with cholestyramine resin, secondary causes of hypercholesterolemia (e.g., poorly controlled diabetes mellitus, hypothyroidism, nephrotic syndrome, dysproteinemias, obstructive liver disease, other drug therapy, alcoholism), should be excluded and a lipid profile performed to assess Total cholesterol, HDL-C and triglycerides (TG). Total cholesterol is a component of the lipid profile that needs to be assessed before initiating therapy with cholestyramine resin.
- It is used in the equation to estimate LDL-C.
- Total cholesterol levels should be determined periodically to confirm initial and adequate long-term response to therapy.
- If LDL-C levels are not available, then Total-C alone may be used to monitor long-term therapy 2.
From the Research
Definition of Total Cholesterol
- Total cholesterol refers to the total amount of cholesterol present in the blood, including both low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol 3, 4, 5, 6.
Components of Total Cholesterol
- Total cholesterol is composed of LDL cholesterol, HDL cholesterol, and other lipoproteins 4, 5.
- LDL cholesterol is often referred to as "bad" cholesterol, while HDL cholesterol is referred to as "good" cholesterol 3, 4.
Relationship with Cardiovascular Disease
- High total cholesterol levels have been associated with an increased risk of cardiovascular disease, including coronary heart disease and stroke 4, 5, 6.
- However, some studies have found that the relationship between total cholesterol and cardiovascular disease is more complex, and that other factors such as HDL and LDL cholesterol levels, as well as triglycerides, may play a more important role in determining cardiovascular risk 3, 5.
Measurement and Significance
- Total cholesterol is typically measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L) of blood 4, 5.
- A high total cholesterol level is generally considered to be above 200 mg/dL or 5.2 mmol/L, although the exact definition of high total cholesterol can vary depending on the individual and their overall health status 6.