What Do My Cholesterol Test Results Mean?

Dr. Kate Bishop |Chief Scientific Officer

Last updated: 29 Mar 2019


Home cholesterol blood test kits allow you to quickly and easily check your blood cholesterol levels from home. But what do the results mean, and what should you do if your cholesterol  levels are too high?


Put simply: the lower your total cholesterol, the better. 

If your total cholesterol is too high then eating healthily and doing regular exercise can help lower the level of cholesterol in your blood. This is also proven to reduce your risk from cardiovascular disease. 

High cholesterol can also be caused by inherited conditions so should be investigated further if other immediate relatives suffer from the condition.

Can my cholesterol be too low?

There has historically been some debate about whether a very low cholesterol level is harmful. Low cholesterol is often seen when there is an existing problem like malnutrition, liver disease, or cancer. However there is no evidence that low cholesterol causes any of these problems.

 

My Cholesterol Ratio is High

Your cholesterol ratio is the ratio of your total cholesterol to HDL (Good Cholesterol) and is also calculated in a cholesterol blood test. The higher the ratio, the greater your risk from heart disease and guidelines indicate that your ratio should be below 4.

There is evidence that your cholesterol ratio is a better indicator of the risk of heart disease than looking at LDL (bad cholesterol levels) alone.

My HDL Cholesterol (Good Cholesterol) is Low

HDL cholesterol carries cholesterol away from your artery walls, so higher levels are better. The higher your HDL cholesterol level, the lower your risk of developing cardiovascular disease.

Lack of exercise, smoking and high alcohol consumption can reduce your HDL cholesterol. It can also be temporarily lowered during sudden illness, or recovering from surgery or an accident.

If your Good Cholesterol is too low, then increasing it is recommended - the higher the better.

This can be achieved through losing weight, avoiding smoking, exercising more and maintaining a healthy diet. Low-carb and ketogenic diets have been shown to increase HDL cholesterol.

  • Increased physical activity can lower your triglycerides while increasing your HDL levels. Just 60 minutes of moderate intensity aerobic exercise a week can show measurable benefits.
  • Try to avoid trans fats in your diet, as they can both increase LDL cholesterol and lower HDL cholesterol levels. This means reducing your intake of most fried foods as well as baked goods such as cakes, biscuits, frozen pizza etc.
  • Reducing dietary saturated fat can also be beneficial, for example by lowering your intake of full-fat dairy products and choosing leaner cuts of meat. A diet which emphasises fruits, vegetables, whole grains, low-fat dairy products, poultry, fish and nuts is recommended.
  • If you smoke, please find a way to stop! Smoking reduces your HDL levels, especially in women, and increases LDL levels and triglycerides.
  • Moderate alcohol use can actually help raise your HDL levels, but if you don't drink, don't start. Too much alcohol can cause weight gain, and might increase your blood pressure and triglyceride levels.

 

My LDL Cholesterol (Bad Cholesterol) is High

There is strong evidence that high levels of LDL Cholesterol increase your risk of developing cardiovascular disease. If your cholesterol ratio is high and you have other risk factors - including obesity, family history, smoking etc - then targeting a LDL Cholesterol level of  2.0 mmol/L is usually recommended by Doctors in the UK. A fall of 30% from your current level can also be seen as a significant reduction. 

If you are not considered to be at high risk of cardiovascular disease, then while there is no official target below 3.0 mmol/L is seen as desirable.

The first step in treating high LDL Cholesterol is adoption of a healthy diet. This especially means reducing saturated fat intake and increasing foods which are known to lower LDL levels. These include vegetables, oats, soya and nuts.

If diet is not successful, your doctor may prescribe statins. These medications are well established and proven to be effective with a low rate of side effects.

My Non-HDL Cholesterol is High

There is no set "normal" or "abnormal" value for non-HDL cholesterol. However, high values are associated with increased risk of cardiovascular disease, so the lower it is, the better.


My Triglyceride blood levels are High

Your cholesterol blood test will also measure the level of triglycerides, another type of blood fat (known as a lipid). Triglycerides are a form of dietary fat found in meats, dairy produce and cooking oils.

Unlike cholesterol, it is not certain whether triglycerides contribute to the risk of cardiovascular disease or whether underlying conditions such as diabetes or obesity are the problem.

However, there is evidence to suggest that this is the case so it is generally recommended to to keep your blood levels low - especially if you are already at risk of cardiovascular disease.

There are many causes of high triglycerides, which include inheritable traits, having a high fat or high sugar diet, high intake of alcohol, obesity and diabetes.

Healthier lifestyle changes to consider include:

 

  • Try to lower the saturated fat, trans fat, and cholesterol in your diet. Cutting back on carbohydrates should help too.
  • Eating more oily fish such as mackerel, sardines, tuna and salmon which are high in omega-3s, a fat that’s good for you. It may be hard to get enough omega-3s from food so you can also consider supplements.
  • Increased exercise & weight loss.  If you’re carrying extra pounds, especially around your belly, losing 5% to 10% of your weight can lower triglycerides. 
  • Reduced alcohol consumption. Not only is alcohol high in sugar and calories, it can have a significant effect on your triglyceride levels.

If these steps are insufficient your doctor may prescribe drugs to help reduce your triglyceride levels.


Similar home testing articles:

Cholesterol: The Good & The Bad

Essential Health Checks

What Do My Cholesterol Test Results Mean?: References & Citations

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  2. Tricoci, P., Allen, J.M., Kramer, J.M., Califf, R.M., Smith, S.C. Scientific evidence underlying the ACC/AHA clinical practice guidelines. JAMA. 2009;301:831–841 Crossref PubMed
  3. Institute of Medicine. in: R. Graham, M. Mancher, D.M. Wolman, S. Greenfield, E. Steinberg (Eds.)Clinical Practice Guidelines We Can Trust. National Academies Press, Washington, DC; 2011 Google Scholar
  4. Reiner, Z., Catapano, A.L., De Backer, G. et al, ESC/EAS guidelines for the management of dyslipidaemias: the task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011;32:1769–1818 Crossref PubMed
  5. NICE. National Institute for Health and Care and Excellence. Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. Available at: https://www.nice.org.uk/guidance/cg181. Accessed April 30, 2016. Google Scholar
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  10. Hippisley-Cox, J., Coupland, C., Vinogradova, Y. et al, Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ. 2008;336:1475–1482 Crossref PubMed
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