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LDL Cholesterol

Lipids Biomarker

Sample Needed

Collection Type: Blood

Body System

Related System: Lipids

Overview

Low-density lipoprotein (LDL) cholesterol is the lipoprotein fraction that carries cholesterol from the liver to peripheral tissues. The LDL test measures the concentration of cholesterol within LDL particles, a key driver of plaque formation in arteries (atherosclerosis). Elevated LDL is associated with increased risk of coronary artery disease, heart attack, stroke and peripheral vascular disease. Testing is often done as part of routine lipid screening or when cardiovascular risk factors (chest pain, family history of early heart disease, diabetes, hypertension, smoking, obesity) are present. LDL levels vary by age, sex and life stage—men tend to have higher LDL earlier in life, and LDL often rises after menopause in women; older adults generally show higher values.

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Test Preparation

No special preparation is required

Why Do I Need This Test

Profile: included in a Lipid profile (lipids panel).
Symptoms prompting test: chest pain, shortness of breath, premature cardiovascular events in family, metabolic risk factors.
Conditions diagnosed/monitored: atherosclerotic cardiovascular disease risk assessment, familial hypercholesterolemia, response to lipid-lowering therapy.
Reasons for abnormal levels: diet high in saturated/trans fats, obesity, hypothyroidism, nephrotic syndrome, certain medications, genetic disorders.
Biological meaning: high LDL increases atherosclerotic plaque formation; very low LDL may reflect malnutrition, liver disease or over-treatment.
Lifestyle/family history: sedentary lifestyle, poor diet, smoking, and family history of early heart disease indicate need for testing.

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Understanding Test Results

<100 mg/dL (<2.6 mmol/L): Optimal associated with lower cardiovascular risk.
Target for many high-risk patients (existing heart disease, diabetes).
100–129 mg/dL (2.6–3.3 mmol/L): Near/above optimal acceptable for low-risk individuals but may prompt lifestyle changes.
130–159 mg/dL (3.4–4.1 mmol/L): Borderline high increased risk; consider diet/exercise and repeat testing.
160–189 mg/dL (4.1–4.9 mmol/L): High elevated risk of atherosclerotic disease; often requires therapeutic lifestyle changes and possibly medication.
≥190 mg/dL (≥4.9 mmol/L): Very high suggests familial hypercholesterolemia or severe dyslipidemia; usually requires prompt pharmacologic treatment.
Low LDL (e.g., <50 mg/dL) is uncommon and can reflect malabsorption/malnutrition, advanced liver disease, hyperthyroidism or aggressive lipid-lowering therapy; clinically, very low LDL may warrant evaluation for underlying causes or medication adjustment.

Normal Range

0-99 mg/dL OR 0-2.6 mmol/L

FAQs

Q: What happens when LDL is high?

A: High LDL (“bad”) cholesterol deposits cholesterol in artery walls, forming plaque (atherosclerosis). This narrows and stiffens arteries, reduces blood flow, and raises risk of coronary artery disease, heart attack, stroke, and peripheral artery disease. Plaque can inflame or rupture, causing clots. High LDL is often symptomless until complications occur. Diet, exercise, quitting smoking and cholesterol-lowering medicines lower LDL and reduce risk.

Q: How do I lower my LDL quickly?

A: To lower LDL quickly, see your doctor about starting a statin (often reduces LDL within weeks). Simultaneously adopt heart-healthy changes: cut saturated/trans fats, eat soluble fiber (oats, beans), use plant sterols, lose excess weight, exercise 150 minutes/week, quit smoking, and limit alcohol. If LDL stays high, doctors may add ezetimibe or PCSK9 inhibitors; recheck lipids as advised.

Q: What is a normal LDL level?

A: Normal (optimal) LDL cholesterol is generally under 100 mg/dL. Levels 100–129 mg/dL are near optimal, 130–159 borderline high, 160–189 high, and ≥190 mg/dL very high. People with established cardiovascular disease or very high risk often have a treatment target below 70 mg/dL. Discuss targets with your clinician because risk factors can change recommendations.

Q: Is LDL of 144 bad?

A: An LDL of 144 mg/dL is considered borderline high (moderately elevated). It modestly raises cardiovascular risk, but significance depends on overall risk factors age, blood pressure, smoking, diabetes, and family history. Clinicians typically advise lifestyle changes (diet, exercise, weight loss) and may consider lipid‑lowering medication if your overall risk is high. Discuss personalized management with your clinician.

Q: What to avoid if LDL is high?

A: If LDL cholesterol is high, avoid saturated and trans fats (fried foods, fatty meats, full-fat dairy, processed snacks), excessive refined carbs and sugary drinks, smoking, heavy alcohol use, and a sedentary lifestyle. Also limit processed meats, packaged baked goods, and excess salt; follow a heart-healthy diet, maintain healthy weight, and consult your clinician about medications if needed.

Q: Is high LDL curable?

A: High LDL cholesterol usually isn’t “curable,” but it can be very effectively controlled. Lifestyle changes—healthy diet, exercise, weight loss and smoking cessation—can lower levels, and many people need medicines (for example statins, ezetimibe or PCSK9 inhibitors) to reach targets. Genetic forms often require lifelong treatment. Regular monitoring and treating other health issues helps reduce cardiovascular risk.