Cardiologist Reveals 2 Cholesterol Numbers Every Man Should Watch to Prevent Heart Attacks
Mention the word "cholesterol" and suddenly, everyone in the conversation is tense. High cholesterol affects about 10 percent of Americans ages 20 and up, but cholesterol itself isn’t necessarily a bad thing. Your body actually needs it to build cells and produce hormones. It becomes a problem when you have too much of it. Excess cholesterol can build up in the arteries, forming plaque that narrows and hardens the arteries, increasing the risk of heart attack.
Getting screened for cholesterol is an important measure for early detection, giving you the time to make necessary lifestyle changes or begin medication. The most important numbers your doctor looks at are low-density lipoprotein (LDL) cholesterol ("bad" cholesterol) and non-high-density lipoprotein (non-HDL) cholesterol.
"While all cholesterol numbers—including total cholesterol triglycerides and HDL cholesterol ("good" cholesterol)—are important, it’s not the main driver of cardiac risk," says Daniel Tran, D.O., FACC, of RWJBarnabas Health. "Think of LDL and non-HDL as the numbers most closely tied to plaque buildup in the heart arteries, which is what we’re really trying to prevent."
LDL measures the cholesterol carried by particles most likely to stick to artery walls. Non-HDL measures cholesterol carried on LDLs, VLDLs, and other particles known to cause plaque buildup. Together, these numbers help estimate your risk for atherosclerosis: the slow, progressive buildup of plaque in the arteries over time.
Plaque buildup can occur in any artery of the body, including the heart, brain, arms, and legs. Higher LDL and non-HDL cholesterol are key contributors in this process, which increases the risk of heart attack and stroke. Luckily, cholesterol is one of the most treatable heart risk factors—especially if caught early.
"In general, an LDL under 100 mg/dL is considered healthy, and under 55 mg/dL is
often the goal for people at higher heart risk," Tran explains. "For non-HDL, we typically like to see under 130 mg/dL in general, or under 100 mg/dL for people at higher risk."
Still, your ideal target depends on your overall cardiovascular risk, which may include family history, known heart disease, diabetes, or active smoking. Review your results with your doctor so the numbers are interpreted in the full context of your health.
How Often Should I Test My Cholesterol?
Cholesterol screening frequency truly depends on your big picture—meaning, individual health situation. The goal is to catch it early, and adjust lifestyle choices to reduce cardiovascular risk before they become a bigger issue.
"For most men in their 40s and 50s, checking cholesterol every one to two years is
reasonable if levels are normal and overall risk is low," Tran says. "If you have risk factors like high blood pressure, diabetes, family history, or you’re already on cholesterol medication, we usually recommend testing more frequently, between six to 12 months."
Related: The 5 Heart Tests Men Over 50 Should Never, Ever Skip, According to Cardiologists