Understanding and

Interpreting Your Cholesterol

Blood TestJune 23, 2020 at 4:00 PM ET

Presenter: Joseph DeBoe, DNPModerator: Andrea Baer, MS, BCPA

• All attendees are in listen only mode• If you can not hear, check the audio button on your

personal computer to assure the sound is on.• Please type your questions into the chat box at any

time during the presentation. The moderator will read your questions during the question and answer period.

• The PDF version of the slides, as well as the recording of this presentation will be available on the Mended Hearts website following the event.

Mended Hearts’ mission is “to inspire hope and improve the quality of life of heart patients and their families through ongoing peer-to-peer support, education and advocacy.”

The National Lipid Association’s (NLA) mission is “to enhance the practice of lipid management in clinical medicine.”

The Foundation of the NLA’s mission is “to improve the welfare of patients and families affected by cholesterol and triglyceride problems.”

Andrea Baer, MS, BCPAExecutive DirectorMended Hearts

Joseph DeBoe, DNPClinical Assistant ProfessorUniversity of Arizona

@LipidDNP24

Understanding and Interpreting your Cholesterol Blood Test

Joseph DeBoe, DNPClinical Assistant Professor

University of Arizona @LipidDNP24

Financial Disclosures

• Nothing to disclose

Understanding and Interpreting your Cholesterol Blood test

• Topics of discussion• Lipids and what they are• What is a lipid panel?• How often should you get your lipid blood test

performed?• How to understand and interpret your lipid blood test• What the “numbers” mean for you and adherence to a

life-long healthy lifestyle

What are Lipids?

•Lipids are fats that are normally found in our blood•Normal levels help us function properly •Higher than normal levels can cause significant health problems particularly as we age

The Two Main Types of Lipids in our Blood

•Cholesterol oTwo main types

•Triglycerides

This Photo by Unknown Author is licensed under CC BY

Cholesterol: Two Main Types

•LDL (low-density lipoprotein)o“bad” cholesterol

•HDL (high-density lipoprotein)o“good” cholesterol

This Photo by Unknown Author is licensed under CC BY-NC-ND

LDL Cholesterol

•Typically referred to as the “bad” cholesterol

•When the LDL levels in your blood are too high it can cause damage to your body by clogging or blocking blood vessels as you age

HDL Cholesterol

•Typically referred to as the “good” cholesterol

•Helps your body get rid of excess cholesterol that may otherwise collect in your blood vessels

This Photo by Unknown Author is licensed under CC BY-SA-NC

Triglycerides (TG)

• Type of fat found in your blood stream that provides fuel to help your body operate properly (just like your car needs gasoline)

•Mostly from your diet, however, we also make them

•When we eat, we take the TGs we do not need and store them in fat cells to use later as fuel

• Too much TGs can cause significant health problems

How Do I Find Out My Lipid Levels?

• Your healthcare provider will order a lipid blood panel in order to measure the levels of lipids in your blood stream

• This blood panel is typically ordered in adults over the age of 20 years at least once every 5 years• Your healthcare provider may recommend the panel be

performed if you are at heightened risk for: • Heart disease

• Stroke

• Or other complications

What is a Lipid Blood Panel?• A lipid blood panel is a measurement of the fats in your

blood stream

• The typical standard lipid panel measures your body’s:• Total Cholesterol• Triglycerides• LDL• HDL• Non-HDL• VLDL • Cholesterol/HDL Ratio

What Do All Of These Numbers Mean?

This Photo by Unknown Author is licensed under CC BY

Total Cholesterol (TC)

•Measures your “good” plus “bad” cholesterol

•High levels of TC can increase your risk of cardiovascular disease

•Can be falsely elevated when your HDL is very high

•Typically recommend TC under 200 mg/dl

Triglycerides (TG)

•Best to be measured when fasting

•High levels of TG (>150 mg/dL) can increase your risk of cardiovascular disease

•Very high levels of TG (>500 mg/dL) can increase your risk of pancreatitis (irritation of the pancreas) and other health problems

Cholesterol/HDL Ratio•This value is found by dividing your Total Cholesterol by your HDL

•Although this ratio is shown on many lipid panels, its usefulness is unknown

•Use of the Cholesterol/HDL-C ratio in evaluating health risks is not recommended and it should not influence your healthcare decisions

HDL Cholesterol (The Good Guys)

•Higher levels are usually associated with lower risk of cardiovascular disease

•Normal or high levels may be less effective in lowering risk if LDL and non-HDL are significantly elevated (especially in high or very high-risk patients)

•HDL levels can lower in your body if you smoke, have an extremely low-fat diet, or have high level of TG’s

•HDL level should ideally be >40 mg/dL

VLDL Cholesterol (A Bad Guy)• VLDL is created in your liver to carry TGs throughout your

body

• The main difference between VLDL and LDL is that they have different percentages of the cholesterol, protein, and TGs that make up each particle

• VLDL contains more TGs whereas LDL contains more cholesterol

• Elevated levels of VLDL can significantly increase heart disease and stroke

• Ideal levels in your blood should be <29 mg/dL

LDL Cholesterol (THE WORST Guy)• Most decisions to treat patients for cholesterol issues by

your healthcare provider are based on LDL

• The optimal level of LDL in your blood stream depends on the risk factors involved

• Patients at higher risk (previous stroke, heart attack, diabetes, smoking, age, and family history) require a lower goal of LDL in the blood stream

• Normal LDL levels are determined by the risk factors

• High-risk patients should have an LDL level of <100 mg/dL

• Patients with known disease (heart attack, stroke, etc.) should have an LDL of <70 mg/dL

Non-HDL Cholesterol (Combo of Bad Guys)• Non-HDL Cholesterol is a number that is calculated to

provide a useful measure of all the “bad” cholesterol in your blood stream

• It is measured by subtracting HDL from the TC

• The calculated non-HDL cholesterol has been shown to more accurately predict the risk of developing cardiovascular disease (heart attack or stroke)

• Ideally, your non-HDL should be 30 mg/dL or less above your LDL goal• Example: If your LDL goal is 100 mg/dL, then your non-HDL goal

would be 130 mg/dL or less

Final Thoughts on the Lipid Blood Panel• This was an overview of the standard measurements

of the lipids in your blood

• This particular blood panel is typically drawn when you have your annual physical or any cholesterol/lipid medication adjustment by your healthcare provider

• There are other lipid particles and genetic studies (we can save those for another session ) that we did not discuss here that your healthcare provider may perform for you depending on your particular health situation and lifestyle

Questions and Discussion

Thank You Very Much!

For additional questions, please email:Andrea.baer@mendedhearts.org

Join us for the next session of the series:

The Important Role of Nutrition in Heart HealthJuly 16, 2020 at 3:00 PM ET

Presenter: Penny Kris-EthertonModerator: Andrea Baer, MS, BCPA

This webinar series is brought to you by Mended Hearts, The National Lipid Association (NLA), and The Foundation of the NLA.This activity is supported by Amgen, Esperion, and Novartis.