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Cholesterol Management

Cholesterol Management: What it is, How to manage it | National Heart Centre Singapore

Cholesterol Management - What it is

Cholesterol is a fat-like substance that is produced by the body or derived from food. It is necessary for the body to function normally and is used to build cell walls, though it takes only a small amount of in the blood to meet those needs. The cholesterol is carried through one’s bloodstream by special proteins called lipoproteins.

There are two types of lipoproteins. One is low-density lipoprotein (LDL) or “bad” cholesterol, which will increase the build-up of fats in the arteries. The other is high-density lipoprotein (HDL) or “good” cholesterol, which removes cholesterol from the cells before they are deposited as plaque in the arteries.

The goal is to keep your total cholesterol level as low as possible. Any excess cholesterol in the blood may be deposited in the arteries, including the coronary arteries. This build-up causes hardening and narrowing of the arteries, causing blood flow to the heart to be reduced or blocked. If there is insufficient blood and oxygen to the heart, one may experience chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, heart attack may occur.

Cholesterol Management - Symptoms

Cholesterol Management - How to prevent?

Cholesterol Management - Causes and Risk Factors

Cholesterol Management - Diagnosis

Cholesterol Management - Treatments

Cholesterol Management - Preparing for surgery

Cholesterol Management - Post-surgery care

Cholesterol Management - Other Information

Check cholesterol levels regularly

Several common factors that can increase your cholesterol levels include heredity, diet, weight, physical inactivity, age, gender, alcohol, and stress.

However, high blood cholesterol itself does not cause symptoms. Therefore, it is important to check your cholesterol level regularly, to reduce your susceptibility to coronary heart disease.

If your total cholesterol level is between 5.2 and 6.1mmol/L, you are at an increased risk for coronary heart disease. If your total cholesterol level registers at 6.2 mmol/L and above, you are having hypercholesterolaemia, which is attributable to genetic factors, diabetes mellitus, obesity, and poor eating habits.

The desirable level of LDL depends on your preexisting risk for coronary heart disease. If you already have coronary artery disease, peripheral vascular disease, or diabetes, you are in the high-risk group and the desirable level is more stringent. Conversely, if you have none or only one risk factor, a higher value of LDL is acceptable before medical intervention.

HDL protects against heart disease, so the higher HDL levels, the better. A level less than 1.0 mmol/L is low and is considered a risk factor. The risk of heart disease is lower when HDL level is 1.0 mmol/L or more. Women usually tend to have higher HDL cholesterol levels than men.

Higher-than-normal levels of triglyceride also put you at a greater risk of cardiovascular disease. Elevated triglyceride levels are more common in people who are obese or those with poorly controlled diabetes. As you get older and more overweight, your trigylceride and cholesterol levels tend to increase.


Classification of Total, LDL and HDL Cholesterol and Triglyceride Levels

​Total Blood Cholesterol (mmol/L [mg/dL])
< 5.2 (200)​​Desirable
​5.2 – 6.1 (200 – 239)
​Borderline High
​≥ 6.2 (240)
​High
​​LDL Cholesterol (mmol/L [mg/dL])
​< 2.6 (100)
​Optimal
​2.6 – 3.3 (100 – 129)
​Desirable
​3.4 – 4.0 (130 – 159)
​Borderline high
​4.1 – 4.8 (160 – 189)
​High
​≥ 4.9 (190)
​Very High
HDL Cholesterol (mmol/L [mg/dL])​
​< 1.0 (40)
Low​
1.0 – 1.5 (40 – 59)​
Desirable​
​≥ 1.6 (60)
High​
​Triglyceride (mmol/L [mg/dL])​
< 1.7 (150)​
Optimal​
1.7 – 2.2 (150 – 199)​
Desirable​
​2.3 – 4.4 (200 – 399)
High​
​≥ 4.5 (400)
Very high​

HDL=high-density lipoprotein; LDL=low-density lipoprotein 
Source: MOH Clinical Practice Guidelines 2/2006
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