How does cholesterol affect heart disease risk?

The nicknames "good" and "bad" cholesterol relate to risk factors for heart disease. High levels of high density lipoproteins (HDL), or "good" cholesterol, are linked to lower heart disease risk; high levels of low density lipoproteins (LDL), or "bad" cholesterol, are associated with higher heart disease risk. Remember, keep you HDL levels High and your LDL levels Low.

Cholesterol is a waxy, fat-like substance found in all the cells of your body, and it can be helpful or harmful, depending on how much you have and what it's up to.

Together, all the fatty acids in your blood ("good" high-density lipoprotein [HDL] cholesterol, "bad" low-density lipoprotein [LDL] cholesterol, triglycerides, etc.) make up your cholesterol levels. And if you have too much of the bad fats making up your cholesterol levels, it can increase your risk for cardiovascular disease, a leading cause of death for both women and men in the United States.

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The more low-density lipoproteins (LDL) or bad cholesterol in your bloodstream, the greater your heart risk. The National Cholesterol Education Program (NCEP), a division of the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH), has been evaluating the evolving medical evidence and issuing cholesterol guidelines for several decades. The current guidelines identify LDL levels below 100 milligrams per deciliter (mg/dL) as optimal; those 100 to 129 as near to above optimal; 130 to 159 as borderline high; 160 to 189 as high, and greater than 190 as very high.

By contrast, the more high-density lipoproteins (HDL) or good cholesterol in your bloodstream, the lower your chances of having a heart attack. Findings from the Framingham Heart Study (a long-running landmark study of factors contributing to heart disease) and elsewhere suggest that every one-point rise in HDL lowers the risk for heart attack 2% to 3%. The NCEP guidelines consider levels of 60 mg/dL or above as protective against heart disease, while levels below 40 mg/dL increase your risk.