謄固醇的常識(Cholesterol) - Harvard School of Public Health

Cholesterol Levels

AHA Recommendation


Cholesterol plays a major role in a person's heart health. High blood cholesterol is a major risk factor for coronary heart disease and stroke. That's why it's important for all people to know their cholesterol level. They should also learn about their other risk factors for heart disease and stroke.
Total blood cholesterol is the most common measurement of blood cholesterol. It's the number you receive as test results. Cholesterol is measured in milligrams per deciliter of blood (mg/dL).
Blood cholesterol for adults is classified by levels. Your healthcare provider must interpret your cholesterol numbers based on other risk factors such as age, gender, family history, race, smoking, high blood pressure, physical inactivity, obesity and diabetes.


The American Heart Association endorses the National Cholesterol Education Program (NCEP) guidelines for detection of high cholesterol.The Third Report of the Expert panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III or ATP III) was released in 2001. It recommends that everyone age 20 and older have a fasting "lipoprotein profile" every five years. This test is done after a 9–12-hour fast without food, liquids or pills. It gives information about total cholesterol, low-density lipoprotein (LDL) or "bad" cholesterol, high-density lipoprotein (HDL) or "good" cholesterol and triglycerides (blood fats).
Researchers have established healthy ranges for each of these. They're given in the lists below. If a fasting lipoprotein profile isn't possible, the values for total cholesterol and HDL cholesterol are acceptable.

Initial classification based on total cholesterol and HDL cholesterol

Total Cholesterol Level	Category
Less than 200 mg/dL	Desirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dL or higher raises your risk.
200 to 239 mg/dL	Borderline high
240 mg/dL and above	High blood cholesterol. A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL.

HDL Cholesterol Level	Category
Less than 40 mg/dL (for men) Less than 50 mg/dL (for women)	Low HDL cholesterol. A major risk factor for heart disease.
60 mg/dL and above	High HDL cholesterol. An HDL of 60 mg/dL and above is considered protective against heart disease.

If your total cholesterol is 200 mg/dL or more, or your HDL cholesterol is less than 40 mg/dL (for men) and less than 50 mg/dL (for women),you need to have a lipoprotein profile done to determine your LDL cholesterol and triglyceride levels. If your cholesterol is high or you have other risk factors, your healthcare provider will likely want to monitor your cholesterol more closely. Follow your provider's advice about how often to have your cholesterol tested. He or she will set appropriate management goals based on your LDL cholesterol level and other risk factors.

LDL Cholesterol Level	Category
Less than 100 mg/dL	Optimal
100 to 129 mg/dL	Near or above optimal
130 to 159 mg/dL	Borderline high
160 to 189 mg/dL	High
190 mg/dL and above	Very high

Your LDL cholesterol goal depends on how many other risk factors you have.^†

• If you don't have coronary heart disease or diabetes and have one or no risk factors, your LDL goal is less than 160 mg/dL.
• If you don't have coronary heart disease or diabetes and have two or more risk factors, your LDL goal is less than 130 mg/dL.
• If you do have coronary heart disease or diabetes, your LDL goal is less than 100 mg/dL.

Triglyceride is the most common type of fat in the body. Many people who have heart disease or diabetes have high triglyceride levels. Normal triglyceride levels vary by age and sex. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol seems to speed up atherosclerosis (the buildup of fatty deposits in artery walls).  Atherosclerosis increases the risk for heart attack and stroke.

Triglyceride Level	Category
Less than 150 mg/dL	Normal
150–199 mg/dL	Borderline high
200–499 mg/dL	High
500 mg/dL and above	Very high

On the whole, Americans should reduce the amount of saturated fat,trans fat, cholesterol and total fat in their diet. If you have high blood cholesterol, it's very important to control high blood pressure, avoid tobacco smoke, eat a healthy diet, get regular physical activity, maintain a healthy weight, and control or delay the onset of diabetes. Taking these steps will help lower your risk of heart disease and stroke. If you still need drugs to reduce your blood cholesterol, a healthy diet and active lifestyle will help lower your cholesterol and improve your overall cardiovascular health.

^† Electronic 10-year risk calculators are available at http://hp2010.nhlbihin.net/atpiii/calculator.asp?usertype=pub.

Related AHA Scientific Statements
Cholesterol
Related AHA publications:

• Heart and Stroke Facts
• Your Guide to Lowering Your Cholesterol with TLC - Therapeutic Lifestyle Changes
• Making Healthy Food and Lifestyle Choices brochure
• Easy Food Tips for Heart-Healthy Eating brochure (also in Spanish)
• "What Do My Cholesterol Levels Mean?" and "How Can I Lower High Cholesterol?" in Answers By Heart kit (also in Spanish kit)
• "What Are High Blood Cholesterol and Triglycerides?" and "What Is Cholesterol-Lowering Medicine?" in Answers By Heart kit