AMERICAN HEART ASSOCIATION CHOLESTEROL GUIDELINES:^1*

TOTAL BLOOD CHOLESTEROL LEVEL
Your total blood cholesterol will fall into one of these categories:

Desirable
If your total cholesterol is less than 200 mg/dL, your heart attack risk is relatively low, unless you have other risk factors. Even with a low risk, it's still smart to eat foods low in saturated fat and cholesterol, and also get plenty of physical activity. Have your cholesterol levels measured every five years — or more often if you're a man over 45 or a woman over 55.

Borderline High Risk
People whose cholesterol level is from 200 to 239 mg/dL are borderline high risk. About a third of American adults are in this (borderline) group; almost half of adults have total cholesterol levels below 200 mg/dL.

Have your cholesterol and HDL re-checked in one to two years if:

• Your total cholesterol is in this range.
• Your HDL is less than 40 mg/dL.
• You don’t have other risk factors for heart disease.

You should also lower your intake of foods high in saturated fat and cholesterol to reduce your blood cholesterol level to below 200 mg/dL. Your doctor may order another blood test to measure your LDL cholesterol. Ask your doctor to discuss your LDL cholesterol with you. Even if your total cholesterol is between 200 and 239 mg/dL, you may not be at high risk for a heart attack. Some people — such as women before menopause and young, active men who have no other risk factors — may have high HDL cholesterol and desirable LDL levels. Ask your doctor to interpret your results. Everyone's case is different.

High risk
If your total cholesterol level is 240 or more, it's definitely high. Your risk of heart attack and stroke is greater. In general, people who have a total cholesterol level of 240 mg/dL have twice the risk of heart attack as people whose cholesterol level is 200 mg/dL.  You need more tests. Ask your doctor for advice. About 20 percent of the U.S. population has high blood cholesterol levels.

LDL CHOLESTEROL
Your LDL cholesterol level greatly affects your risk of heart attack and stroke. The lower your LDL cholesterol, the lower your risk. In fact, it’s a better gauge of risk than total blood cholesterol. Your LDL cholesterol will fall into one of these categories:

The key point to remember is, the lower your LDL cholesterol, the lower your risk. Your doctor may prescribe a diet low in saturated fat and cholesterol, regular exercise and a weight management program if you're overweight. If you can't lower your cholesterol with these efforts, medications may also be prescribed to lower your LDL cholesterol. Check these categories and the goals for treatment that can lower your risk of heart attack.

HDL CHOLESTEROL
In the average man, HDL cholesterol levels range from 40 to 50 mg/dL. In the average woman, they range from 50 to 60 mg/dL. HDL cholesterol that's less than 40 mg/dL is low. Low HDL cholesterol puts you at high risk for heart disease. Smoking, being overweight and being sedentary can all result in lower HDL cholesterol. If you have low HDL cholesterol, you can help raise it by:

• Not smoking
• Losing weight (or maintaining a healthy weight)
• Being physically active for at least 30–60 minutes a day on most or all days of the week

People with high blood triglycerides usually have lower HDL cholesterol and a higher risk of heart attack and stroke. Progesterone, anabolic steroids and male sex hormones (testosterone) also lower HDL cholesterol levels. Female sex hormones raise HDL cholesterol levels.

CHOLESTEROL RATIO
Total blood cholesterol is the most common measurement of blood cholesterol. It's the number you normally receive as test results. Cholesterol is measured in milligrams per deciliter of blood (mg/dL). Knowing your total blood cholesterol level is an important first step in determining your risk for heart disease. However, a critical second step is knowing your HDL or "good" cholesterol level.

Some physicians and cholesterol technicians use the ratio of total cholesterol to HDL cholesterol in place of the total blood cholesterol. The American Heart Association recommends that the absolute numbers for total blood cholesterol and HDL cholesterol levels be used. They're more useful to the physician than the cholesterol ratio in determining the appropriate treatment for patients.

The ratio is obtained by dividing the HDL cholesterol level into the total cholesterol. For example, if a person has a total cholesterol of 200 mg/dL and an HDL cholesterol level of 50 mg/dL, the ratio would be stated as 4:1. The goal is to keep the ratio below 5:1; the optimum ratio is 3.5:1.

TRIGLYCERIDE LEVEL
Your triglyceride level will fall into one of these categories:

Many people with high triglycerides have underlying diseases or genetic disorders. If this is true for you, the main therapy is to change your lifestyle. This includes controlling your weight, eating foods low in saturated fat and cholesterol, exercising regularly, not smoking and, in some cases, drinking less alcohol. People with high triglycerides may also need to limit their intake of carbohydrates to no more than 45–50 percent of total calories. The reason for this is that carbohydrates raise triglycerides in some people and lower HDL cholesterol. Use products with monounsaturated and polyunsaturated fats.