if I have a high cholesterol level?
M.C., Coronado, California
A. When people get together and the subject of health comes up, it's
very common to hear someone ask, “What's your cholesterol level?” If the answer
is 195, people think it's good. However, if the answer is, say, 220, then the
reaction is typically sympathetic.
Most people think anything under 200 is good and anything over that is bad.
But a level of 195 may not be good, and 220 may not be all that bad.
There is good cholesterol and there is bad cholesterol. High-Density
Lipoproteins (HDL) is the “good” cholesterol and Low-Density Lipoproteins (LDL)
is the “bad” cholesterol. The important thing is the ratio between them.
HDL actually helps prevent cardiovascular disease because it helps remove LDL
from blood cells, which means that less LDL can enter into the blood vessel
walls. HDL can reverse the buildup in the arteries and act as a blood-thinning
agent. This is very important to good heart health.
LDL, on the other hand, is very unhealthy for you if the level in your blood
is high. It can cause the inside layers of your arteries to inflame, and fatty
plaques and platelets can begin to build up. The blood can start to thicken, a
process that can lead to heart complications.
Here is the most important fact to know about cholesterol levels: It is not
the individual levels of HDL and LDL or their combined levels that make a big
difference. It is the ratio of HDL to LDL that will determine your risk for
Your total cholesterol divided by your HDL should be less than 4, and your
LDL divided by the HDL should be less than 3.
If your ratios work out to be less than 4 and less than 3 respectively, you
are at a low risk to develop heart disease. If your ratios are higher, your risk
of heart disease is much higher, regardless of what the individual levels of
cholesterol are. That is why a person with a total cholesterol greater than 200
may not be at risk, and a person with a lower cholesterol level may be at great
I recommend that you have your cholesterol levels checked by a doctor and
then work out your ratios. If you see that they are higher than what they should
be, you should ask your doctor and a nutritionist to help you lower them,
preferably through diet and exercise instead of prescription drugs. May you be
blessed with a healthy heart.
Francisco Contreras, M.D., director of Oasis of Hope Hospital in Mexico,
oversees the treatment of 600 cancer patients annually.