How to calculate the total cholesterol (TC) number?
TC is the sum of the LDL level, the HDL level, and 20% of the triglyceride value (put the numbers and the calculator will do the math). The new cholesterol guidelines 2019 recommend that the TC level for people at low risk would be less than 200 mg/dL (US and most of Asia units) or less than 5 mmol/L (UK, Canada, Australia, Ireland, most of Europe units) for healthy adults. For people with coronary artery disease, diabetes, or with other risk factors the total cholesterol recommended level should be less than 180 mg/dL. TC above these level should need on going treatment such as sport, drugs and change of lifestyle.
HDL LDL are waxy substance called plaque which builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle. When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years but the outcome is fatal.
HDL LDL desired level
Ideally, you want your HDL score to be high, and your LDL and triglyceride scores to be low.
The higher your HDL (good Cholesterol), the lower your risk of coronary artery disease. HDL levels greater than 60 mg/dL are optimal. for LDL Less than 100mg/dL is the best.
What Is Cholesterol Ratio and What is the ideal ratio?
Furthermore, even with normal levels of HDL, LDL the ratio between the level may indicate to doctors if a patient might need a treatment or to change is way of life (for example – do more sport…)
The ratios may be used as a monitoring tool, however, the AHA suggests that doctors use total cholesterol numbers with patients and the cholesterol ratio. That’s because the both the levels and the ratios are considered a better tool for guiding the doctor in planning the best patient care and helping patients understand their health risks. You should discuss with your doctor what the best levels to monitor for you .
TC, HDL,LDL, Triglycerides levels chart
Fats which circulate in the blood are often referred to as lipids. The two major lipids in the blood are cholesterol and triglyceride. As fats do not dissolve easily they are carried around the body in ball-like structures which are water soluble. These structures also contain proteins and are called lipoproteins.
There are five major lipoproteins which have been named by the way in which they are separated in the laboratory.
• Very Low Density Lipoproteins (VLDL)
• Intermediate Density Lipoproteins (IDL)
• Low Density Lipoproteins (LDL)
• High Density Lipoproteins (HDL)
All of these lipoproteins contain both cholesterol and triglycerides but in varying amounts e.g. VLDL contain a lot of triglycerides and a little cholesterol and LDL contain a lot of
cholesterol and little triglycerides.
Measured total cholesterol includes cholesterol from all five lipoprotein structures. Hospital laboratories usually measure total cholesterol and HDL- cholesterol and calculate a value for LDL- cholesterol. Chylomicrons are found in the blood only after meals and so are not usually present in fasting samples.
VLDL and IDL-cholesterol are not included in the figure generated by the calculation of LDL-cholesterol.
Non HDL- cholesterol is the sum of all the lipoproteins which contribute towards the development of atherosclerosis
(narrowing of the arteries) and is thought to be a better predictor for cardiovascular disease (CVD) than using LDL cholesterol
alone. It incorporates the harmful elements of the lipoprotein profile to include triglyceride rich remnant particles
from VLDL and IDL, as well as LDL-cholesterol. It is also better for monitoring response to treatments such as lifestyle changes and medication.
It can be calculated by a simple subtraction (TC minus HDL), there is no need to fast for the test and it has been recommended as the target for lipid modification in guidelines by the National Institute for Health and Care Excellence (NICE) and the Joint British Societies (JBS3)
LDL– is calculated using the Friedewald Formula as follows (all measurements are in millimoles per litre/mmol/L):
LDL = Total cholesterol – HDL – (Total triglyceride ÷ 2.19)
The formula used is reasonably accurate providing total triglyceride levels are below 4.5 mmol/L but unreliable when triglycerides are
high due to the effects of triglyceride – remnant particles which will be included in VLDL and IDL measures.
Cholesterol/HDL ratio is another measurement used to determine CVD risk and is obtained by dividing total cholesterol
So just for example a lipid profile may look like this:
Total cholesterol = 5 mmol/L
LDL = 3.49mmol/L
HDL = 1.2 mmol/L
Non-HDL Cholesterol = 3.8mmol/L (5mmol/L minus 1.2mmol/L)
Triglyceride = 0.7 mmol/L
TC/HDL ratio = 4.2 (5 mmol/L ÷ 1.2 mmol/L)