What Do Your Cholesterol Numbers Really Mean?

When many people get back their blood test results, they find their doctor usually recommends a cholesterol-lowering medication like Lipitor - and they don’t want to take it.

In most cases, there is no cause for alarm or medication. 

A short summary based on a large amount of research (Gary Taubes; Good Calories Bad Calories, 2007 and Uffe Ravnskov; Ignore the Awkward! How the Cholesterol Myths Are Kept Alive, 2010):

• Total cholesterol level says little about heart disease risk. It's a "false and highly dangerous guide to the effect of diet on the heart."

• LDL measurement is useless because it combines "fluffy" and "dense" cholesterol - fluffy is benign, while dense may be harmful. Only VLDL (dense) can indicate heart disease risk - if it is higher than 40 mg/dl (1.03 mmol/l).

• Triglycerides predict heart disease for people under 50. For them, high triglycerides accompany both obesity and heart disease.

• For people 50 and over, however, HDL is so far the only reliable predictor of risk. It's usually too low rather than too high. Women: Aim for HDL higher than 50. Men: Aim for higher than 35. HDL should not exceed 75.

HDL is known as the "good cholesterol." It acts like a housekeeper for the blood. It scours the walls of blood vessels, to prevent formation of plaques that cause heart disease.

HDL also decreases inflammation and may protect against things such as Alzheimer's.