What is LDL Cholesterol?
Friday, August 15th, 2008What are LDLs?
Low-density lipoprotein (LDL) belongs to the lipoprotein particle family. Because LDLs transport cholesterol to the arteries and can be retained there by arterial proteoglycans starting the formation of plaques, increased levels are associated with atherosclerosis, and thus heart attack, stroke, and peripheral vascular disease. For this reason, cholesterol inside LDL lipoproteins is often called “bad” cholesterol. This is a misnomer. The cholesterol transported on LDL is the same as cholesterol transported on other lipoprotein particles. The cholesterol itself is not “bad”; rather, it is how and where the cholesterol is being transported, and in what amounts over time, that causes adverse effects.
Increasing evidence has revealed that the concentration and size of the LDL particles more powerfully relates to the degree of atherosclerosis progression than the concentration of cholesterol contained within all the LDL particles. The healthiest pattern, though relatively rare, is to have small numbers of large LDL particles and no small particles. Having small LDL particles, though common, is an unhealthy pattern; high concentrations of small LDL particles (even though potentially carrying the same total cholesterol content as a low concentration of large particles) correlates with much faster growth of atheroma, progression of atherosclerosis and earlier and more severe cardiovascular disease events and death.
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 |
These guidelines were based on a goal of presumably decreasing death rates from cardiovascular disease to less than 2% to 3% per year or less than 20% to 30% every 10 years. Note that 100 is not considered optimal; less than 100 is optimal, though it is unspecified how much less.
Source: Wikipedia, January 28, 2008
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