Nearly 25 million adults in the United States are afflicted with high cholesterol, which increases their susceptibility to heart attacks or strokes within the next decade. However, a significantly larger segment falls into the category of borderline high cholesterol, a state that falls between elevated and normal levels.
High cholesterol is officially diagnosed when an individual’s total cholesterol level reaches 240 mg/dL or higher. Borderline cholesterol, on the other hand, falls within the range of 200 to 239 mg/dL.
Dr. Donald Lloyd-Jones, a past president of the American Heart Association and a professor at Northwestern University Feinberg School of Medicine, explains that these thresholds serve as reference points to gauge an individual’s risk of cardiovascular disease. However, these benchmarks aren’t universally applicable; some individuals may remain healthy with a total cholesterol level of 235, while others could be at risk with a level of 205, contingent upon their other risk factors.
People with total cholesterol levels below 200 generally exhibit a lower risk of heart disease, while those surpassing 240 face a heightened risk. Those falling between 200 and 239 occupy a middle ground, where their risk is neither negligible nor critically high.
While cholesterol levels in this intermediate category aren’t inherently perilous, they do heighten the risk of developing high cholesterol over time. Prolonged exposure to borderline high cholesterol can amplify its deleterious effects, potentially doubling the risk of heart disease compared to those with consistently elevated cholesterol levels.
Dr. Daron Gersch, a family physician at CentraCare Hospital in Long Prairie, Minn., compares this prolonged exposure to marinating arteries in cholesterol particles throughout one’s lifespan. Regardless of the duration, such exposure increases the likelihood of plaque formation within the arteries, leading to heart attacks and strokes.
However, total cholesterol levels don’t provide a complete assessment of cardiovascular risk. Dr. Ann Marie Navar, associate professor of cardiology at UT Southwestern Medical School, emphasizes the importance of monitoring levels of low-density lipoprotein (LDL) cholesterol, often dubbed “bad” cholesterol, which accumulates in the arteries. An LDL level below 100 is considered healthy.
Conversely, high-density lipoprotein (HDL) cholesterol, or “good” cholesterol, aids in removing fats from the blood, offering protective benefits. An HDL level of 60 or higher is considered healthy.
Given these nuances, it may be more pertinent to focus on borderline high LDL cholesterol levels, as LDL cholesterol above 160 is deemed high, while levels between 130 and 159 are considered borderline. However, Navar underscores that cholesterol-related risk exists on a continuum, with no definitive threshold delineating safety from danger. As LDL levels persistently rise, so too does the cumulative risk of cardiovascular complications over time.
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