An in-depth guide from the team at Paradise Medical Center Primary Care in Miami, FL.
Call (305) 676-8217Cholesterol numbers can feel confusing — total, LDL, HDL, triglycerides, non-HDL, ApoB, Lp(a). What do they mean, and which actually matter for your heart risk?
Here's a clear breakdown of what each number means, what your targets should be, and how to improve them.
Total cholesterol: The sum — less useful alone than the components.
LDL (low-density lipoprotein): The 'bad' cholesterol that deposits in artery walls. Lower is better.
HDL (high-density lipoprotein): The 'good' cholesterol that removes excess cholesterol. Higher is better.
Triglycerides: Blood fats from carbs and excess calories. Linked to insulin resistance.
Non-HDL cholesterol: Total minus HDL — captures all atherogenic particles. Increasingly used as primary target.
LDL: Under 100 mg/dL for most adults; under 70 for high cardiovascular risk; under 55 for very high risk (prior heart attack, stroke).
HDL: Over 40 (men) / over 50 (women).
Triglycerides: Under 150 mg/dL.
Non-HDL: 30 points above your LDL goal.
These are general guidelines — your provider personalizes targets based on overall cardiovascular risk.
Apolipoprotein B (ApoB): Counts the actual atherogenic particle number — increasingly recognized as a better risk marker than LDL alone. Target generally under 90 mg/dL.
Lipoprotein(a) [Lp(a)]: A genetic risk factor checked once in a lifetime. Elevated Lp(a) raises cardiovascular risk independently and isn't lowered by diet or exercise.
hsCRP: Marker of vascular inflammation; elevated levels predict cardiovascular events.
These advanced markers are particularly valuable for patients with strong family history or borderline standard lipids.
Diet: Reduce saturated fat (red meat, full-fat dairy), eliminate trans fats, increase soluble fiber (oats, beans, apples), include plant sterols (fortified foods, nuts).
Mediterranean diet consistently improves all lipid markers.
Exercise: Regular aerobic activity modestly lowers LDL and substantially raises HDL.
Weight loss: 5–10% loss often improves all lipid markers — see our medical weight loss guide.
Statins: When lifestyle isn't enough or risk is significant. Reduce LDL 30–55%, with strong evidence for cardiovascular protection.
Newer agents: Ezetimibe, PCSK9 inhibitors, bempedoic acid, inclisiran — used when statins alone don't reach goal or aren't tolerated.
Quit smoking
Aerobic exercise (most effective intervention)
Lose excess weight
Replace refined carbs with healthy fats (olive oil, nuts, avocado)
Limit alcohol (excess raises triglycerides)
Note: medications targeting HDL specifically have not improved outcomes — focus is on raising HDL through lifestyle and lowering LDL pharmacologically.
Reduce sugar and refined carbohydrates
Lose excess weight
Limit alcohol
Increase omega-3 (fatty fish 2x weekly or supplementation)
Address underlying conditions (diabetes, thyroid)
Medications: fibrates, prescription omega-3s, niacin in selected cases.
Statins are the most studied class of medications in modern medicine — proven to reduce heart attack and stroke risk substantially. Common concerns:
Muscle aches: Real but often resolved by switching statin or adjusting dose. True muscle injury is rare.
Diabetes risk: Small increase but cardiovascular benefits substantially outweigh.
Liver effects: Generally minor; bloodwork monitoring detects issues early.
Most patients tolerate statins well long-term. Read the American Heart Association cholesterol resource.
Healthy adults: Every 4–6 years; annually after age 40 or with risk factors.
On treatment: 4–12 weeks after starting/adjusting medication, then yearly.
Family history of early heart disease: More frequent monitoring with advanced markers.
All testing through our in-office lab services.
Ready to learn more? Visit our dedicated service page or call (305) 676-8217 to schedule a consultation.
Cholesterol causes no symptoms until it causes a heart attack or stroke. Treatment is preventive.
Lifestyle alone works for some patients. Higher-risk patients benefit substantially from medications.
Recent evidence suggests dietary cholesterol matters less than saturated/trans fats. Most people can eat eggs in moderation.
Lifestyle changes show results in 6–12 weeks. Statins reach full effect in 4–6 weeks.
Some patients with statin-related muscle aches benefit; evidence is mixed. Discuss with your provider.
Speak with our medical team about a personalized plan.
Call (305) 676-8217