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Cholesterol testing and results

Cholesterol test results; LDL test results; VLDL test results; HDL test results; Coronary risk profile results; Hyperlipidemia-results; Lipid disorder test results

 

Cholesterol is a soft, wax-like substance found in all parts of the body. Your body needs a little bit of cholesterol to work properly. But too much cholesterol can clog your arteries and lead to heart disease.

Cholesterol blood tests are done to help you and your health care provider better understand your risk for heart disease, stroke, and other problems caused by narrowed or blocked arteries.

The ideal values for all cholesterol results depend on whether you have heart disease, diabetes, or other risk factors. Your provider can tell you what your goal should be.

Cholesterol Tests

 

Some cholesterol is considered good and some is considered bad. Different blood tests can be done to measure each type of cholesterol.

Your provider may order only a total cholesterol level as the first test. It measures all types of cholesterol in your blood.

You may also have a lipid (or coronary risk) profile, which includes:

  • Total cholesterol
  • Low density lipoprotein (LDL cholesterol)
  • High density lipoprotein (HDL cholesterol)
  • Triglycerides (another type of fat in your blood)
  • Very low density lipoprotein (VLDL cholesterol)

Lipoproteins are made of fat and protein. They carry cholesterol, triglycerides, and other fats, called lipids, in the blood to various parts of the body.

 

When Should You Be Tested?

 

Everyone should have their first screening test by age 35 for men, and age 45 for women. Some guidelines recommend starting at age 20.

You should have a cholesterol test done at an earlier age if you have:

  • Diabetes
  • Heart disease
  • Stroke
  • High blood pressure
  • A strong family history of heart disease

Follow-up testing should be done:

  • Every 5 years if your results were normal
  • More often for people with diabetes, high blood pressure, heart disease, stroke, or blood flow problems to the legs or feet
  • Every year or so if you are taking medicines to control high cholesterol

 

Total Cholesterol

 

A total cholesterol of 180 to 200 mg/dL or less is considered best.

You may not need more cholesterol tests if your cholesterol is in this normal range.

 

LDL (Bad) Cholesterol

 

LDL cholesterol is sometimes called "bad" cholesterol. LDL can clog your arteries.

You want your LDL to be low. Too much LDL is linked to heart disease and stroke.

Your LDL is most often considered to be too high if it is 190 mg/dL or higher.

Levels between 70 and 189 mg/dL are most often considered too high if:

  • You have diabetes and are between ages 40 and 75
  • You have diabetes and a high risk of heart disease
  • You have a medium or high risk of heart disease

Health care providers have traditionally set a target level for your LDL cholesterol if you are being treated with medicines to lower your cholesterol.

  • Some newer guidelines now suggest that providers no longer need to target a specific number for your LDL cholesterol. Higher strength medicines are used for the highest risk patients.
  • However, some guidelines still recommend using specific targets.

 

HDL (Good) Cholesterol

 

You want your HDL cholesterol to be high. Studies of both men and women have shown that the higher your HDL, the lower your risk of coronary artery disease. This is why HDL is sometimes referred to as "good" cholesterol.

HDL cholesterol levels greater than 40 to 60 mg/dL are desired.

 

VLDL (Bad) Cholesterol

 

VLDL contains the highest amount of triglycerides. VLDL is considered a type of bad cholesterol, because it helps cholesterol build up on the walls of arteries.

Normal VLDL levels are from 2 to 30 mg/dL.

 

Considerations

 

Sometimes, your cholesterol levels may be low enough that your provider will not ask you to change your diet or take any medicines.

 

 

References

American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37 Suppl 1:S14-S80.

Gennest J, Libby P. Lipoprotein disorders and cardiovascular disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 45.

Pencina MJ, Navar-Boggan AM, D'Agostino RB Sr, Williams K, Neely B, Sniderman AD, Peterson ED. Application of new cholesterol guidelines to a population-based sample. N Engl J Med. 2014 Apr 10;370(15):1422-1431. PMID: 24645848 www.ncbi.nlm.nih.gov/pubmed/24645848.

Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. J Am Coll Cardiol. 2014 Jul 1;63(25 Pt B):2889-934. PMID: 24239923 www.ncbi.nlm.nih.gov/pubmed/24239923.

Stone NJ, Robinson JG, Lichtenstein AH, Goff DC Jr, Lloyd-Jones DM, Smith SC Jr, et al. Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: Synopsis of the 2013 American College of Cardiology/American Heart Association cholesterol guideline. Ann Intern Med. 2014 Mar 4;160(5):339-43.

 
  • Understanding cholesterol results

    Understanding cholesterol results

    Animation

  •  

    Understanding cholesterol results - Animation

    LDL cholesterol has gotten a bad reputation, and for very good reason. Having too much of this fatty substance in your blood can clog up your arteries, preventing blood from getting to your heart and out to where it's needed in your body. Checking your LDL levels can help your doctor spot high cholesterol before it can cause a heart attack or stroke. Let's talk today about LDL tests. LDL stands for low-density lipoprotein. Lipoprotein is a type of protein that transports cholesterol, as well as fats called triglycerides and lipids, in your blood. When you eat too many fatty, cholesterol-rich foods, LDL cholesterol can start to collect in your artery walls. That's one collection you don't want, because if a chunk of that gunk breaks loose and gets lodged in a blood vessel, you could end up having a heart attack or stroke. To check your LDL cholesterol level, you'll need to have a blood test. Your doctor may tell you not to eat or drink anything for 8 to 12 hours before the test, so you can get an accurate reading. During the test, your doctor will draw blood from one of your veins. The needle might sting a little bit, but the feeling shouldn't last for any more than a few seconds. So, how do you know that you have high LDL cholesterol? Well, your LDL cholesterol level (think L for Lousy) will usually be measured along with your HDL, or good cholesterol (think H for Healthy), as well as your triglycerides and your total cholesterol level. Together, these measurements are called a lipid panel. You want your LDL level to be at least below 130 mg/dl, but ideally less than 100 milligrams per deciliter. If you're at high risk of heart disease, it should be even lower than that -- less than 70 milligrams per deciliter. And for folks of average risk of getting heart disease, anything over 160 is considered a high LDL level. If you do have LDL cholesterol, you could be at risk for heart disease. Now, some folks have high cholesterol because they have an inherited condition that causes high cholesterol. If your LDL is low, it may be because you're not eating a well-balanced diet or your intestines aren't absorbing the nutrients from the foods that you eat. Ask your doctor how often you should have your LDL, and total cholesterol levels, checked. Depending upon your heart disease risks, you may need to be tested more often. If your LDL cholesterol is high, ask your doctor about cholesterol-lowering medications, diet, and other ways to bring it back down into a normal range.

  • Heart disease modifiable risk factors - hyperlipidemia

    Heart disease modifiable risk factors - hyperlipidemia

    Animation

  •  

    Heart disease modifiable risk factors - hyperlipidemia - Animation

    Lifestyle changes and lipid-lowering medicines can be key factors to help fight hyperlipidemia.

  • Cholesterol

    Cholesterol - illustration

    Cholesterol is a soft, waxy substance that is present in all parts of the body including the nervous system, skin, muscle, liver, intestines, and heart. It is made by the body and obtained from animal products in the diet. Cholesterol is manufactured in the liver and is needed for normal body functions including the production of hormones, bile acid, and Vitamin D. Excessive cholesterol in the blood contributes to atherosclerosis and subsequent heart disease. The risk of developing heart disease or atherosclerosis increases as the level of blood cholesterol increases.

    Cholesterol

    illustration

  • Understanding cholesterol results

    Animation

  •  

    Understanding cholesterol results - Animation

    LDL cholesterol has gotten a bad reputation, and for very good reason. Having too much of this fatty substance in your blood can clog up your arteries, preventing blood from getting to your heart and out to where it's needed in your body. Checking your LDL levels can help your doctor spot high cholesterol before it can cause a heart attack or stroke. Let's talk today about LDL tests. LDL stands for low-density lipoprotein. Lipoprotein is a type of protein that transports cholesterol, as well as fats called triglycerides and lipids, in your blood. When you eat too many fatty, cholesterol-rich foods, LDL cholesterol can start to collect in your artery walls. That's one collection you don't want, because if a chunk of that gunk breaks loose and gets lodged in a blood vessel, you could end up having a heart attack or stroke. To check your LDL cholesterol level, you'll need to have a blood test. Your doctor may tell you not to eat or drink anything for 8 to 12 hours before the test, so you can get an accurate reading. During the test, your doctor will draw blood from one of your veins. The needle might sting a little bit, but the feeling shouldn't last for any more than a few seconds. So, how do you know that you have high LDL cholesterol? Well, your LDL cholesterol level (think L for Lousy) will usually be measured along with your HDL, or good cholesterol (think H for Healthy), as well as your triglycerides and your total cholesterol level. Together, these measurements are called a lipid panel. You want your LDL level to be at least below 130 mg/dl, but ideally less than 100 milligrams per deciliter. If you're at high risk of heart disease, it should be even lower than that -- less than 70 milligrams per deciliter. And for folks of average risk of getting heart disease, anything over 160 is considered a high LDL level. If you do have LDL cholesterol, you could be at risk for heart disease. Now, some folks have high cholesterol because they have an inherited condition that causes high cholesterol. If your LDL is low, it may be because you're not eating a well-balanced diet or your intestines aren't absorbing the nutrients from the foods that you eat. Ask your doctor how often you should have your LDL, and total cholesterol levels, checked. Depending upon your heart disease risks, you may need to be tested more often. If your LDL cholesterol is high, ask your doctor about cholesterol-lowering medications, diet, and other ways to bring it back down into a normal range.

  • Heart disease modifiable risk factors - hyperlipidemia

    Animation

  •  

    Heart disease modifiable risk factors - hyperlipidemia - Animation

    Lifestyle changes and lipid-lowering medicines can be key factors to help fight hyperlipidemia.

  • Cholesterol

    Cholesterol - illustration

    Cholesterol is a soft, waxy substance that is present in all parts of the body including the nervous system, skin, muscle, liver, intestines, and heart. It is made by the body and obtained from animal products in the diet. Cholesterol is manufactured in the liver and is needed for normal body functions including the production of hormones, bile acid, and Vitamin D. Excessive cholesterol in the blood contributes to atherosclerosis and subsequent heart disease. The risk of developing heart disease or atherosclerosis increases as the level of blood cholesterol increases.

    Cholesterol

    illustration

A Closer Look

 

Talking to your MD

 

    Self Care

     

    Tests for Cholesterol testing and results

     

       

      Review Date: 11/26/2014

      Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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