Total cholesterol

Total cholesterol is the sum of the different lipoproteins that carry cholesterol in the blood stream. LDL and HDL together make up most of the total, but there are smaller amounts of some other lipoproteins that are a part of the total.

Total cholesterol less than 200mg/dl is desirable. The risk for a heart attack or stroke is relatively low, unless there are other risk factors present. To keep the total cholesterol in the desirable range it’s a good idea to eat a healthy diet; low in saturated fat, cholesterol, and trans fats, and plenty of fruits, vegetables, and whole grains. Regular exercise will help keep total cholesterol in the desirable range also. It is recommended to repeat the blood test at least every five years as long as the result is in the desirable range.

Total cholesterol of 200 to 239mg/dl is considered borderline high. About one third of American adults are in this category. The risk for heart attack and stroke may be twice as high as those with total cholesterol less than 200mg/dl. Reducing the amount of saturated fat, cholesterol and trans fats in the diet is important to reduce the total cholesterol to less than 200mg/dl, thereby reducing the risk for heart disease and stroke. Regular exercise may help reduce total cholesterol. If other risk factors for heart disease are present it is important to discuss them also with your primary care provider. A few people with total cholesterol in this range, who have high HDL and normal LDL levels and no other risk factors, may not be at increased risk. Ask your primary care provider to interpret the results for you.

Total cholesterol of 240mg/dl or more is high blood cholesterol. The risk for heart disease and stroke is more than twice that of someone whose total cholesterol is less than 200mg/dl. About one in five American adults have high blood cholesterol. A lipid profile to assess LDL should be done, and repeated after a few months of treatment to make sure the treatment is effective. Treatment for high blood cholesterol includes diet changes to reduce saturated fat, cholesterol and trans fats, exercise, and sometimes medications.

Total Cholesterol Level Category
Less than 200 mg/dl Desirable
200-239 mg/dl Borderline high
240 mg/dl and higher High; more than twice the risk of heart disease compared to a level less than 200