The liver creates a waxy substance called cholesterol and proteins called lipoproteins carries cholesterol throughout the body.
To support cell functions, the body needs a specific amount of cholesterol, but having too much of some forms of cholesterol like bad cholesterol might increase the risk of cardiovascular disease (CVD).
How much of the harmful types of cholesterol you have in your blood can be determined using non-HDL cholesterol, sometimes referred to as non-HDL-C. Additionally, it helps your doctor assess your risk of heart disease.
In this article, we discuss non HDL cholesterol, how to calculate it, how to reduce it, and relation with cardiovascular diseases risk.
Non-HDL cholesterol in a lipid panel
Your doctor will request a blood test known as a lipid panel in order to figure out your cholesterol levels and know your heart diseases risk.
By deducting HDL cholesterol from total cholesterol, doctor can calculate non-HDL cholesterol.
Your doctor might ask for this test if your total cholesterol is high or if you have any of the following conditions:
- obesity
- high blood pressure
- stress
- diabetes or prediabetes
Additionally, a few lifestyle choices could prompt your doctor to check your non-HDL cholesterol:
- imbalanced diet
- smoking
- a lack of consistent activity
According to the University of Rochester Medical Center, you might also undergo additional tests in addition to the lipid panel with non-HDL cholesterol. To further assess your heart health, your doctor may also request:
- Cardiovascular catheterization, which enables doctors to take X-rays to discover blockages in your arteries
- electrocardiogram (ECG) to examine your heartbeat stress test where you exercise while linked to ECG.
These tests all provide your doctors with the data they require to assist you in enhancing and supporting your heart health.
What distinguishes non-HDL cholesterol levels from other cholesterol readings?
A lot of people seek to lower their blood cholesterol levels. However, total cholesterol does not provide the full picture.
Total cholesterol is divided into the following categories to help you understand your risk for heart disease:
- HDL cholesterol, or high-density lipoprotein cholesterol
- Triglycerides
- LDL cholesterol, or low-density lipoprotein cholesterol
- non-HDL cholesterol
Let's examine each type of cholesterol in more detail and what it entails.
- HDL cholesterol
HDL is commonly known as the “good” cholesterol. That is due to the fact that it carries non-HDL cholesterol from the bloodstream to the liver. The body's non-HDL cholesterol is then eliminated by the liver. This helps keep your arteries from accumulating plaque.
Naturally having high HDL levels is beneficial to your health.
- LDL cholesterol
LDL is referred to as "bad" cholesterol. In simple terms, if there are high levels of LDL cholesterol running through your blood vessels, it can, over time, start to accumulate on the sides of those blood vessels. This buildup is typically known as “plaque.”
Plaque buildup in your blood vessels can eventually cause those vessels to become narrower. The narrower your blood vessels are, the harder it is for blood to reach your heart and other organs. Your LDL cholesterol should be as low as it can be.
- Triglycerides
Triglycerides are a type of fat in the blood. You can get it from meals. The University of Rochester Medical Center claims that when you consume more calories than you burn, excess triglycerides can accumulate.
Heart disease has been connected to high blood triglyceride levels. But high triglyceride levels frequently go hand in hand with other diseases, such as diabetes and obesity. Researchers in a 2019 study weren't clear if these other illnesses or triglycerides may be the cause of heart disease.
The aim is to maintain low triglyceride levels, similar to LDL.
Very low-density lipoproteins (VLDL), which are produced in the liver, are related to triglycerides. VLDL can't be precisely measured, hence it won't appear on your report. Usually, the estimate is expressed as a percentage of the triglyceride value. Due to the fact that VLDL carries triglycerides, this is significant. VLDL cholesterol can change into LDL cholesterol over time, according to research.
- Non-HDL cholesterol
Non-HDL cholesterol, as the name suggests, is essentially your total cholesterol number without your HDL cholesterol. It is a measurement of all the "bad" forms of cholesterol. You want this number to be as low as possible, not as high as possible.
What is the non-HDL cholesterol normal range?
The risk of heart disease increases with non-HDL cholesterol levels.
LDL and triglycerides, two types of "bad" cholesterol, make up non-HDL cholesterol. The optimal LDL cholesterol level, according to the CDC, must be fewer than 100 mg/dL and triglyceride levels should be under 150 mg/dL.
More than 36,000 individuals with a low 10-year risk of cardiovascular disease participated in a 2018 study. LDL cholesterol and non-HDL cholesterol values of more than 160 mg/dL were each associated with a 50 to 80 percent increased relative risk of cardiovascular disease death, according to a long-term follow-up.
If you don't have heart or blood vessel disease, the following CDC recommendations for other forms of cholesterol apply to you:
If you have heart disease or are at high risk of developing it, your doctor may have different objectives for you.
Remember that the American College of Cardiology and the American Heart Association are both gradually abandoning the idea of target LDL and non-HDL levels. An alternative to these levels is a risk calculator. For persons without established cardiovascular risk and diabetes, this recommendation predicts the 10-year risk of cardiovascular disease.
If the LDL is 190 or above, medical practitioners will consider statin therapy for this patient. This recommendation takes into account a person's cardiovascular health.
Less than 130 milligrams per deciliter (mg/dL), or 3.37 millimoles per liter (mmol/L), is considered to be the ideal non-HDL cholesterol level. A higher risk of heart disease is indicated by higher numbers.
What does having high non-HDL cholesterol mean?
You may have an increased risk of atherosclerosis, or artery narrowing, if your non-HDL cholesterol level is high. Non-HDL cholesterol increases your heart disease risk and:
- Angina (chest pain), heart attack, and stroke
The CDC states that you may have an even higher chance of developing heart disease if you:
- have diabetes
- have high blood pressure
- are smoking
- have obesity
- have a renal condition
Non-HDL cholesterol is becoming more and more important in studies that evaluate cardiovascular risk.
For instance, data from 9 clinical trials including participants with coronary disease were examined in a 2016 study. They discovered that, compared to LDL, attained non-HDL cholesterol was more strongly connected with the development of illness.
A 2017 study with a 22-year follow-up included more than 4,800 men. The researchers came to the conclusion that non-HDL cholesterol may be more important than LDL when it comes to predicting cardiovascular disease mortality.
How can non-HDL cholesterol be reduced?
Your liver provides all of the cholesterol you need. Additionally, meals including meat, poultry, dairy products, and saturated fats found in baked goods provide some. Furthermore, these foods encourage your liver to produce more cholesterol.
The CDC advises limiting your consumption of saturated fats to lower your total cholesterol levels. This calls for consuming fewer fatty meats and whole-fat dairy products.
Trans fats should be avoided as well. On food labels, these might be identified as partially hydrogenated vegetable oil. They are available in:
- baked foods, such as cakes, pies, cookies, and pastries.
- snack food: Crackers, microwaveable popcorn, frozen pizza crusts, meat pies.
- Fried fast food items include fries, fried chicken, fried noodles, and battered fish.
- vegetable shortening: Frequently used in baked items as a less expensive option to butter.
- Stick margarine is created from vegetable oils with hydrogen.
- Non-dairy coffee creamers: can be used in place of milk and cream in hot beverages like coffee and tea.
If you have access to them, try to concentrate on eating more real foods rather than processed ones. These consist of whole grains, nuts, seeds, and fresh produce. Additionally, look for protein-rich foods like fish, skinless chicken, and lean red meat.
There are some foods that could improve LDL cholesterol levels.
- Oat bran and oatmeal
- Kidney beans
- Apples, pears, almonds, and Brussels sprouts
- Avocados
Following are some foods that could reduce triglycerides:
- Omega-3-rich fish such as salmon, mackerel, herring, tuna, and trout walnuts
- walnuts
- flaxseed oil
- canola oil
Additional methods to lower your cholesterol include:
- Avoiding smoking and engaging in moderate exercise for at least 30 minutes five times a week.
- keeping a moderate weight and reducing alcohol consumption
If altering your lifestyle is ineffective, your doctor may recommend cholesterol-lowering drugs.
- statins
- bile acid sequestrants
- fibrates
- PCSK9 inhibitors
- niacin
How significant are non-HDL cholesterol and the cholesterol ratio?
Many physicians now think that measuring your non-HDL cholesterol level may be more beneficial than calculating your cholesterol ratio for predicting your risk of heart disease. And neither your total cholesterol level nor even your low-density lipoprotein (LDL, or "bad") cholesterol level appears to be a better risk predictor than either choice.
High-density lipoprotein (HDL, or "good") cholesterol is simply subtracted from total cholesterol to calculate non-HDL cholesterol, as the name implies. Therefore, it has all of the "bad" kinds of cholesterol.
Divide your total cholesterol value by your HDL cholesterol number to determine your cholesterol ratio. Your ratio would be 4 to 1 if your total cholesterol was 200 mg/dL (5.2 mmol/L) and your HDL was 50 mg/dL (1.3 mmol/L). Heart disease risk increases with larger ratios.
Briefly
Excessive levels of HDL cholesterol are beneficial, while high levels of non-HDL cholesterol may put you at risk for heart disease.
You may be able to control your non-HDL cholesterol by making certain dietary, physical activity, and smoking cessation adjustments. If it doesn't work, cholesterol can be effectively controlled with medication. If you are unsure of your cholesterol levels, discuss getting tested with your doctor.
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