You just got your blood work back, and there's a page full of cholesterol numbers staring at you. Total cholesterol. HDL. LDL. Triglycerides. What does it all mean? And more importantly, what should you do about it?

If you're feeling confused, you're not alone. Cholesterol is one of those health topics that everyone talks about but few people truly understand. The good news? Once you know what those numbers mean, you can take control of your heart health.

Why Cholesterol Matters

Cholesterol is a waxy, fat-like substance that your body needs to build cells and make certain hormones. But too much of the wrong kind of cholesterol can cause serious problems.

When you have too much cholesterol in your blood, it can build up on the walls of your arteries. This buildup, called plaque, narrows your arteries over time and restricts blood flow to your heart and brain. If blood flow to your heart is blocked, you can have a heart attack. If blood flow to your brain is blocked, you can have a stroke.

Here's why this matters in Texas: Heart disease and stroke account for almost 30% of deaths in Texas. And according to the CDC, Texas is among the states with the highest concentrations of counties with elevated cholesterol prevalence. Knowing your numbers and taking action can significantly lower your risk.

Breaking Down Your Cholesterol Panel

When you get a cholesterol test (also called a lipid panel), you'll see several numbers. Here's what each one means:

Total Cholesterol

This is the sum of all the cholesterol in your blood. It includes your HDL, LDL, and 20% of your triglycerides.

• Desirable: Less than 200 mg/dL
• Borderline high: 200-239 mg/dL
• High: 240 mg/dL or higher

While total cholesterol gives you a big-picture view, it doesn't tell the whole story. You need to look at the individual components to really understand your risk.

LDL Cholesterol (The "Bad" Cholesterol)

LDL stands for low-density lipoprotein. This is the cholesterol that builds up in your arteries and increases your risk of heart disease and stroke. That's why it's called "bad" cholesterol.

• Optimal: Less than 100 mg/dL
• Near optimal: 100-129 mg/dL
• Borderline high: 130-159 mg/dL
• High: 160-189 mg/dL
• Very high: 190 mg/dL or higher

The lower your LDL, the better. Recent guidelines recognize that "lower is better" when it comes to LDL cholesterol, especially if you have other risk factors for heart disease.

HDL Cholesterol (The "Good" Cholesterol)

HDL stands for high-density lipoprotein. This is the cholesterol that helps remove LDL cholesterol from your blood and carries it back to your liver, where your body gets rid of it. Higher levels of HDL can lower your risk for heart disease and stroke.

• Optimal for men: 40 mg/dL or higher
• Optimal for women: 50 mg/dL or higher
• Ideal: 60 mg/dL or higher

With HDL, higher is better. If your HDL is too low (below 40 for men or below 50 for women), you're at increased risk for heart disease, even if your LDL is in a good range.

Triglycerides

Triglycerides aren't technically cholesterol — they're a type of fat in your blood that your body uses for energy. But high triglycerides, especially when combined with low HDL or high LDL, can increase your risk for heart attack and stroke.

• Normal: Less than 150 mg/dL
• Borderline high: 150-199 mg/dL
• High: 200-499 mg/dL
• Very high: 500 mg/dL or higher

High triglycerides often go hand-in-hand with other conditions like obesity, diabetes, and metabolic syndrome. Lifestyle changes can make a big difference in bringing these numbers down.

What Affects Your Cholesterol?

Some factors that influence your cholesterol levels are within your control, and some aren't.

Factors you can't change:

• Age (cholesterol tends to rise as you get older)
• Sex (men typically have higher cholesterol until women reach menopause, then women's levels often rise)
• Family history (high cholesterol can run in families)
• Race and ethnicity (certain groups have higher risk)

Factors you can change:

• Diet (eating foods high in saturated and trans fats raises LDL)
• Weight (being overweight or obese tends to raise LDL and lower HDL)
• Physical activity (being inactive lowers HDL)
• Smoking (damages blood vessels and lowers HDL)

The good news? Even if you have risk factors you can't control, the lifestyle changes you make can still have a big impact on your cholesterol levels and heart health.

When and How Often to Get Tested

Most healthy adults should have their cholesterol checked every 4 to 6 years starting at age 20. But you may need to get tested more often if you:

• Have high cholesterol
• Have a family history of high cholesterol or heart disease
• Have diabetes
• Are overweight or obese
• Smoke
• Have high blood pressure

Children should also be screened. The American Heart Association recommends a first lipid panel between ages 9-11 and a second screening between ages 17-21, then every 5 years after that.

Talk to your doctor about how often you should be tested based on your individual risk factors.

What to Do if Your Numbers Are High

If your cholesterol numbers come back higher than they should be, don't panic. There's a lot you can do to improve them.

Start with lifestyle changes:

• Eat a heart-healthy diet low in saturated and trans fats
• Get at least 150 minutes of moderate exercise per week
• Lose weight if you're overweight
• Quit smoking
• Limit alcohol

Consider medication if needed:

If lifestyle changes alone don't bring your numbers down, your doctor may recommend cholesterol-lowering medication, typically a statin. Statins have decades of research showing they work to lower LDL cholesterol and reduce the risk of heart attack and stroke.

Don't be afraid of medication if you need it. While lifestyle changes are important, sometimes they're not enough on their own, especially if you have a family history of high cholesterol or other risk factors.

The Bottom Line

Understanding your cholesterol numbers is one of the most important things you can do for your heart health. Those numbers tell you where you stand and what you need to do next.

The key is to get tested regularly, know what your numbers mean, and work with your doctor to create a plan, whether that's lifestyle changes, medication, or both. Small changes today can prevent serious health problems down the road.

Taking Control of Your Heart Health

Ready to understand your cholesterol and take control of your heart health? Your primary care physician can help you get tested, interpret your results, and create a personalized plan. Find a primary care physician who can help you manage your cholesterol and overall heart health.

For more detailed information about what your specific cholesterol numbers mean, check out Decoding the Diagnosis: Cholesterol.

To learn about heart-healthy eating strategies, read Eat Your Way to Good Heart Health.

Sources

• CDC: About Cholesterol
• CDC: LDL and HDL Cholesterol and Triglycerides
• CDC: High Cholesterol Facts
• Texas Department of State Health Services: Texas Council on Cardiovascular Disease and Stroke State Plan
• MedlinePlus: Cholesterol Levels: What You Need to Know
• National Center for Biotechnology Information: Cholesterol Levels - StatPearls
• Texas Health Resources: Decoding the Diagnosis: Cholesterol