What does it mean to have a "heart-healthy" cholesterol — the actual numbers?

A "heart-healthy" lipid profile for a middle-risk man over 40 with no prior cardiovascular events: ApoB below 80 mg/dL, LDL-C below 100 mg/dL, non-HDL-C below 130 mg/dL, triglycerides below 150 mg/dL, HDL-C above 40 mg/dL, Lp(a) below 50 mg/dL, and for high-risk men (prior cardiovascular event, diabetes, familial hypercholesterolemia): ApoB below 65 mg/dL, LDL-C below 70 mg/dL, and Lp(a) management depending on absolute level (Grundy et al., JACC, 2019).

The "heart-healthy" label applied to foods and diets is largely a marketing construct, products can carry the label based on narrow criteria that do not reflect the complete lipid picture. The actual clinical definition requires all components of the lipid panel to be in the ideal range, not just one metric. A man with LDL-C of 85 mg/dL but triglycerides of 220 mg/dL and ApoB of 110 mg/dL does not have a "heart-healthy" lipid profile despite the appealing LDL number.

Honesty Scale: Solid (1) for these as the evidence-based best lipid targets.

What to do: Print the table above and ask your physician to go through each value at your next appointment. Track all five (ideally six with Lp(a)) metrics, not just LDL-C.

For the full picture, read The ApoB/Lp(a)/Lipids Deep Dive