|
Although an
elevated total cholesterol is associated with an increased heart
attack risk, other tests are more predictive.
|
1. |
|
Total cholesterol.
This is the simplest and least expensive test. Total
cholesterol doesn't vary much after you've eaten, so you
don't have to worry about fasting.
But total cholesterol can be misleading. It includes
both "good" high-density lipoprotein (HDL) cholesterol,
and the "bad" varieties, chiefly low-density lipoprotein
(LDL) and very-low-density lipoprotein (VLDL). So if
your total cholesterol is in the desirable category,
it's possible that you may have unhealthy levels of HDL
(too low) and LDL and VLDL (too high). Think of total
cholesterol as a first glimpse, a peek. Doctors do not
make any treatment decisions based on this number alone.
|
|
|
|
|
|
2. |
|
Total cholesterol and HDL .
HDL wins its laurels as the "good" cholesterol because
it sponges up cholesterol from blood vessel walls and
ferries it to the liver for disposal. In contrast, LDL
deposits the harmful fat in vessel walls.
-
No fasting is necessary for this test. An HDL
measurement is informative by itself and, in
relation to total cholesterol, expressed as the
total cholesterol-to-HDL ratio.
-
According to guidelines, an HDL level of 60 or above
is protective against heart disease, and below 40
makes you vulnerable to it.
-
Reports from the Framingham Heart Study suggest that
for men, a total cholesterol-to-HDL ratio of 5
signifies that they're at average risk for heart
disease; 3.4, about half the average; and 9.6, about
double the average. Women tend to have higher HDL
levels, so for them, a ratio of 4.4 signifies
average risk; 3.3 is about half the average; and 7,
about double.
|
|
|
|
|
|
3. |
|
Lipids (Total, HDL
["good" cholesterol], Ratio, LDL ["bad" cholesterol] &
Triglycerides)
The
lipid profile includes total cholesterol, HDL-cholesterol
(often called “good” cholesterol), ratio, calculated LDL-cholesterol
(often called “bad” cholesterol), and triglycerides.
The LDL measurement is usually considered the most
important for assessing risk and deciding on treatment.
You
have to fast for about 12 hours before the test because
triglyceride levels can shoot up 20%-30% after a meal,
which would throw off the equation. Alcohol also causes
a triglyceride surge, so you shouldn't drink alcohol for
24 hours before a fasting cholesterol test.
The tests that make up a
lipid profile are tests that have been shown to be good
indicators of whether someone is likely to have a heart
attack or stroke caused by blockage of blood vessels
(hardening of the arteries). |
|