The Importance of the
The published evidence is quite clear in documenting that
the actual total cholesterol level itself is not the most
important risk factor of cardiovascular disease.
It is the ratio between the level of HDL-"good" cholesterol
and total cholesterol that we need to be concerned about.
Therefore, in adults, the HDL-"good" cholesterol/total cholesterol ratio should be higher than 0.24 (just divide your HDL level
by your cholesterol).
Or more precisely, the HDL/total cholesterol ratio:
Generally speaking, the higher the ratio, the better (the lower your risk of a heart attack).
However, HDL is closely related to triglycerides.
It appears common for people with high triglycerides
to have low HDL's, and these same people also tend to
have high levels of clotting factors in their blood stream,
which is unhealthy in protecting against heart disease.
Therefore, in adults, the triglyceride/HDL-"good" cholesterol
ratio should be below 2 (just divide your triglycerides
level by your HDL).
Or more precisely, the triglyceride/HDL ratio:
2 or less is considered ideal
4 - high
6 - much too high
And, since HDL (high density lipoprotein) is protective
against heart disease, the lower the ratio, the better.
In other words, the lower your triglycerides, or the
higher your HDL, the smaller this ratio becomes.
It is now believed that the triglycerides/HDL ratio is
one of the most potent predictors of heart disease.
A Harvard-lead study author reported:
"High triglycerides alone increased the risk of heart
attack nearly three-fold.
And people with the highest ratio of triglycerides to
HDL -- the "good" cholesterol -- had 16 times the risk
of heart attack as those with the lowest ratio of triglycerides
to HDL in the study of 340 heart attack patients and 340
of their healthy, same age counterparts.
The citation stated, the ratio of triglycerides to HDL was
the strongest predictor of a heart attack, even more accurate
than the LDL/HDL ratio.
JM, Hennekens CH, O'Donnell CJ, Breslow JL, Buring JE. Fasting
triglycerides, high-density lipoprotein, and risk of myocardial
1997 Oct 21;96(8):2520-5.
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