Today i booked myself to see the local nurse at my GP. This was prompted by my Boots cholesterol test. I wanted to know my HDL ratio.
My blood pressure is 130/70 mmHg.
I am overweight: 12st 13lbs, height 5'7.5" hence BMI 28.3 (BMI calculator). I'm more at risk from high blood pressure, high cholesterol or diabetes.
A blood sample test:
- Total Cholesterol (TC): 5.1
- HDL ratio (TC/HDL): 5.0
- LDL: 3.0
By my calculation HDL = 5.1/5.0 = 1.02 mmole / Litre (40 mg/dL). From the table below I have (borderline) low HDL levels with a heightened risk of heart disease.
Recommended HDL range
HDL levels and risk for heart disease are:-
| Level mg/dL | Level mmol/L | Interpretation |
| <40 | <1.03 | Low HDL cholesterol, heightened risk for heart disease, <50> |
| 40-59 | 1.03-1.52 | Medium HDL level |
| >60 | >1.55 | High HDL level, optimal condition considered protective against heart disease |
More sophisticated laboratory methods measure not just the total HDL but also the range of HDL particles, e.g. "lipoprotein subclass analysis", typically divided into several groups by size, instead of just the total HDL concentration as listed above. The largest groups (most functional) of HDL particles have the most protective effects. The groups of smallest particles reflect HDL particles which are not actively transporting cholesterol, thus not protective.
Certain changes in lifestyle can have a positive impact on raising HDL levels:
- Aerobic exercise
- Weight loss
- Smoking cessation
- Removing trans fatty acids from the diet
- Adding monounsaturated and polyunsaturated fats to the diet
- Drinking 1-2 servings of alcoholic beverages per day
- Adding soluble fiber to diet
- Limiting intake of dietary fat to 30-35% of total calories
- Consumption of Niacin (immediate release crystallin form of Vitamin B3) can increase HDL levels by 15-30%
Recommended LDL range
The American Heart Association, NIH and NCEP provide a set of guidelines for fasting LDL-Cholesterol levels, estimated or measured, and risk for heart disease. As of 2003, these guidelines were:
| Level mg/dL | Level mmol/L | Interpretation |
|---|---|---|
| <100 | <2.6 | Optimal LDL cholesterol, corresponding to reduced, but not zero, risk for heart disease |
| 100 to 129 | 2.6 to 3.3 | Near optimal LDL level |
| 130 to 159 | 3.3 to 4.1 | Borderline high LDL level |
| 160 to 189 | 4.1 to 4.9 | High LDL level |
| >190 | >4.9 | Very high LDL level, corresponding to highest increased risk of heart disease |
At 3.0 mmoles/ Litre (~ 115mg/dL) test result for LDL I have near optimal LDL level.
NB. My total cholesterol analysed by Boots last month was 5.2mmoles/L.
My LDL-C is 115 mg/dL (3.0 mmole/l)
My HDL-C is 40 mg/dL (1.02 mmole/l)
Diagram source Postgraduate Medicine online.
Although statin therapy has revolutionized management of coronary heart disease (CHD), the lowering of low-density lipoprotein cholesterol (LDL-C) levels is not the whole story. Increased plasma concentrations of high-density lipoprotein cholesterol (HDL-C) have a cardioprotective effect that is just as important for reducing risk of heart attack and stroke.
Blood Pressure
Blood pressure values are stated in millimetres of mercury (mmHg). The systolic pressure is defined as the peak pressure in the arteries during the cardiac cycle; the diastolic pressure is the lowest pressure (at the resting phase of the cardiac cycle).
Typical values for a resting, healthy adult human are approximately 120 mmHg systolic and 80 mmHg diastolic (written as 120/80 mmHg), with large individual variations. These measures of blood pressure are not static, but undergo natural variations from one heartbeat to another or throughout the day (in a circadian rhythm); they also change in response to stress, nutritional factors, drugs, or disease.
Normal values of blood pressure
Normal ranges for blood pressure in adult humans are:
Clinical trials demonstrate that people who maintain blood pressures at the low end of these pressure ranges have much better long term cardiovascular health and are considered optimal. The principal medical debate is the aggressiveness and relative value of methods used to lower pressures into this range for those who don't maintain such pressure on their own. Elevations, more commonly seen in older people, though often considered normal, are associated with increased morbidity and mortality. The clear trend from double blind clinical trials is that lower Blood Pressure is found to result in less disease.
My ResultsWith these results (TC/HDL ratio = 5.0, Systolic Blood Pressure = 130, Age 50, Non Smoker) I calculate my risk of CHD (Coronary Heart Disease) - see diagram below as " less than 15% risk of CHD over next 10 years". Or from the European Study the risk of a fatal CardioVascular Event is 1%-2% over the next 10 years.
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