Cholesterol

How High is Too High?

The National Cholesterol Educational Program has developed guidelines for cholesterol levels along with the American Heart Association:

  • Normal levels: Diet & Exercise Tx: Medication Tx:
  • Total Cholesterol < 200 mg/dl, 200-239 mg/dl, > 240 mg/dl
  • Triglycerides < 150 mg/dl, 150-159 mg/dl, > 200 mg/dl
  • HDL 40-60 mg/dl ———– < 40 mg/dl
  • LDL < 100 mg/dl, 100-159 mg/dl, > 160 mg/dl
  • Ratio 3.1 – 5.1 ———– > 5.1

What can I do?

These are some easy steps you can take to lower your blood cholesterol or prevent it from getting too high.

  1. Cut back on saturated and total fat. Choose poultry, fish, and lean meats. Remove the skin and fat from meat. Drink skim or 1% milk rather than 2% or whole milk. Use tub margarines or liquid polyunsaturated oils rather than butter, lard and hydrogenated vegetable shortening.
  2. Cut back on dietary cholesterol. Eat less organ meats, limit liver to one time a month. Limit egg yolks to 3 per week.
  3. Increase complex carbohydrates and fiber. Eat more whole grain breads and cereals, pasta, rice and dried peas and beans.
  4. Lose weight. Eat fewer daily calories (cutting back on the fat in your diet will really help). Burn extra calories by exercising regularly.
  5. Read Labels. Look for hidden saturated fats, such as coconut, palm, palm kernel, animal fat, or hydrogenated vegetable oil.

A registered dietician can help you make these changes or answer any questions you may have.

4/89 (Diane Alberts, Dietetic Intern)

6/02 (Updated by Jill Stoops APN/CNP)

New Cholesterol Guidelines (For adults 20 years and older)

  • Normal levels: Diet & Exercise Tx*: Medication Tx*:
  • Total Cholesterol < 200 mg/dl, 200-239 mg/dl, > 240 mg/dl
  • Triglycerides < 150 mg/dl, 150-159 mg/dl, > 200 mg/dl
  • HDL 40-60 mg/dl ———– < 40 mg/dl
  • LDL < 100 mg/dl, 100-159 mg/dl, > 160 mg/dl
  • Ratio 3.1 – 5.1 ———– > 5.1

Major Risk Factors:

  1. Age: Men > 55 yrs old, Women > 45 yrs old.
  2. Family History: of coronary heart disease before age 55 yrs old.
  3. Cigarette Smoking
  4. High Blood Pressure
  5. HDL -cholesterol below 40 mg/dl
  6. Diabetes
  7. Stroke, or occlusive peripheral vascular disease.
  8. Severe Obesity: > 30% overweight.

When to screen: Who to screen:

  • Every 5 years All adults older than 20 years old.
  • Annually Adults with 2+ risk factors.
  • Annually Adults with total cholesterol 200-239 mg/dl and 2+ risk factors.
  • Annually All people with total cholesterol 240 mg/dl and greater.
  • If you are on medication for treatment of high cholesterol, it is recommended that you also participate in an exercise program and healthy diet.

Tx = treatment.

Colyar, M. (2002).
Lipoprotein Analysis.
Advance for Nurse Practitioners, 10 (5), 30-32.