What is a cholesterol test. How often should you get tested. Who needs cholesterol screening. What do cholesterol numbers mean. How to prepare for a cholesterol test. Why is cholesterol testing important for heart health.

The Importance of Cholesterol Testing in Cardiovascular Health

Cholesterol testing plays a crucial role in assessing cardiovascular health. According to recent statistics, from 2017 to 2020, a staggering 86.4 million U.S. adults aged 20 or older had high or borderline high cholesterol levels. This silent threat often goes unnoticed, as high cholesterol typically doesn’t present any symptoms. The only reliable way to determine your cholesterol status is through a simple blood test known as a “lipid profile.”

Is cholesterol testing necessary for everyone? The short answer is yes. Even individuals who feel healthy should undergo regular cholesterol screenings. This proactive approach allows for early detection and management of potential cardiovascular risks.

Understanding the Components of a Cholesterol Test

A comprehensive cholesterol test examines several key components:

• Low-density lipoprotein (LDL) or “bad” cholesterol
• High-density lipoprotein (HDL) or “good” cholesterol
• Triglycerides
• Total cholesterol

Each of these components provides valuable insights into your cardiovascular health. High levels of LDL cholesterol can lead to plaque buildup in your arteries, increasing the risk of heart disease and stroke. Conversely, higher levels of HDL cholesterol are beneficial, as they help remove excess cholesterol from your bloodstream.

The Role of Triglycerides in Cholesterol Testing

Triglycerides, while not a type of cholesterol, are an essential part of the lipid profile. These fats serve as an energy source for your body. However, elevated triglyceride levels, especially when combined with high LDL or low HDL cholesterol, can significantly increase your risk of heart attack and stroke.

Frequency of Cholesterol Testing: Guidelines and Recommendations

How often should you get your cholesterol checked? For most healthy adults, cholesterol screening is recommended every 4 to 6 years. However, certain groups may require more frequent testing:

• Individuals with heart disease
• People with diabetes
• Those with a family history of high cholesterol
• Children and adolescents at specific age ranges

When should children have their cholesterol checked? The current guidelines suggest at least once between ages 9 and 11, and again between ages 17 and 21. Children with obesity or diabetes may need more frequent screenings.

Preparing for Your Cholesterol Test: What You Need to Know

Preparing for a cholesterol test is relatively straightforward. In most cases, you’ll need to fast for 8 to 12 hours before the test. This means refraining from eating or drinking anything except water. Why is fasting necessary for a cholesterol test? Fasting helps ensure accurate measurements of triglycerides and LDL cholesterol levels, which can be affected by recent food intake.

Always consult with your healthcare provider about specific preparations for your cholesterol test. They may have additional instructions based on your individual health circumstances.

Interpreting Your Cholesterol Test Results

Understanding your cholesterol test results is crucial for managing your cardiovascular health. While specific numbers are important, they’re just one part of the overall picture. Your healthcare team will consider various factors when interpreting your results:

• Family history
• Age and sex
• Lifestyle factors (e.g., smoking)
• Other health conditions
• Blood pressure management

How do healthcare professionals use cholesterol test results? These results, combined with other health factors, help determine your overall cardiovascular risk. This comprehensive assessment guides decisions about lifestyle changes or potential cholesterol-lowering medications.

The Significance of LDL and HDL Cholesterol Levels

LDL cholesterol, often referred to as “bad” cholesterol, is a primary focus in cholesterol management. High levels of LDL can lead to arterial plaque buildup, increasing the risk of heart disease and stroke. On the other hand, HDL cholesterol plays a protective role by helping remove excess cholesterol from the bloodstream.

What are optimal cholesterol levels? While individual targets may vary, generally:

• Total cholesterol: Less than 200 mg/dL
• LDL cholesterol: Less than 100 mg/dL
• HDL cholesterol: 60 mg/dL or higher
• Triglycerides: Less than 150 mg/dL

Advanced Cardiovascular Risk Assessment: Beyond Basic Cholesterol Testing

In some cases, healthcare providers may recommend additional tests to assess cardiovascular risk more comprehensively. One such test is the coronary artery calcium (CAC) scan. How does a CAC scan contribute to cholesterol management? This non-invasive test detects and quantifies calcium deposits in the coronary arteries, providing valuable information about the presence and extent of coronary artery disease.

The 2018 ACC/AHA Guidelines emphasize a more personalized approach to cholesterol management. This approach considers an individual’s lifetime cardiovascular risk, taking into account factors such as:

• Age (particularly for those 45 to 75 years old)
• Presence of diabetes
• Comorbidities
• Blood pressure treatment status
• Smoking history

Managing High Cholesterol: Lifestyle Changes and Treatment Options

If your cholesterol test results indicate high levels, your healthcare provider may recommend various management strategies. These often include a combination of lifestyle modifications and, in some cases, medication.

Lifestyle Modifications for Cholesterol Management

What lifestyle changes can help lower cholesterol levels? Some effective strategies include:

• Adopting a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins
• Increasing physical activity
• Maintaining a healthy weight
• Quitting smoking
• Limiting alcohol consumption

Medication Options for Cholesterol Management

In cases where lifestyle changes alone are insufficient, your healthcare provider may prescribe cholesterol-lowering medications. Common types include:

• Statins
• Bile acid sequestrants
• Cholesterol absorption inhibitors
• PCSK9 inhibitors

How do these medications work? Each type targets cholesterol through different mechanisms, either by reducing production, increasing removal from the bloodstream, or inhibiting absorption in the intestines.

The Impact of High Cholesterol on Different Age Groups

High cholesterol affects individuals across all age groups, but its implications can vary. Recent studies have shown concerning trends in cholesterol levels among younger populations. From 2009 to 2016, approximately 1 in 5 adolescents had an unhealthy cholesterol measurement.

Why is early cholesterol screening important for children and adolescents? Early detection allows for timely intervention, potentially preventing the development of cardiovascular disease later in life. For children with obesity or diabetes, more frequent cholesterol screenings may be necessary due to their increased risk.

Cholesterol Management in Older Adults

As individuals age, the approach to cholesterol management may need adjustment. The 2018 ACC/AHA Guidelines emphasize the importance of considering an individual’s overall health status and life expectancy when making treatment decisions for older adults.

How does age affect cholesterol treatment decisions? For adults over 75, the benefits and risks of cholesterol-lowering therapies should be carefully weighed. Factors such as frailty, comorbidities, and potential medication interactions play a crucial role in determining the most appropriate management strategy.

The Role of Genetics in Cholesterol Levels

While lifestyle factors significantly influence cholesterol levels, genetics also play a crucial role. Familial hypercholesterolemia (FH) is a genetic disorder characterized by very high LDL cholesterol levels from birth. This condition affects approximately 1 in 250 people worldwide.

How does genetic testing contribute to cholesterol management? For individuals with a strong family history of high cholesterol or premature cardiovascular disease, genetic testing can help identify inherited disorders like FH. Early diagnosis allows for more aggressive management strategies, potentially reducing the risk of cardiovascular events.

The Interplay Between Genetics and Lifestyle

Even with a genetic predisposition to high cholesterol, lifestyle factors remain crucial. How can individuals with genetic risk factors manage their cholesterol? A combination of heart-healthy lifestyle choices and appropriate medical management can significantly reduce the impact of genetic factors on cholesterol levels and overall cardiovascular risk.

Emerging Research and Future Directions in Cholesterol Management

The field of cholesterol management continues to evolve, with ongoing research exploring new treatment options and risk assessment methods. Recent studies have focused on novel biomarkers that may provide additional insights into cardiovascular risk beyond traditional lipid profiles.

What are some promising areas of cholesterol research? Some emerging topics include:

• The role of inflammation in atherosclerosis and its relationship to cholesterol
• Development of new targeted therapies for cholesterol management
• Personalized medicine approaches based on genetic and metabolic profiles
• Investigation of the gut microbiome’s influence on cholesterol metabolism

How might these research directions impact future cholesterol testing and management? As our understanding of cholesterol and cardiovascular health deepens, we can expect more sophisticated risk assessment tools and tailored treatment strategies to emerge, potentially leading to more effective prevention and management of cardiovascular disease.

The Global Impact of High Cholesterol: A Public Health Perspective

High cholesterol is not just an individual health concern; it’s a global public health issue. According to the World Health Organization, raised total cholesterol is a major cause of disease burden in both developed and developing countries. It’s estimated to cause 2.6 million deaths annually worldwide.

How are different countries addressing the challenge of high cholesterol? Many nations have implemented public health initiatives aimed at reducing cholesterol levels and improving cardiovascular health. These efforts often include:

• Educational campaigns about heart-healthy lifestyles
• Policies to reduce trans fats in food supplies
• Improved access to cholesterol screening and treatment
• Promotion of physical activity and healthy eating in schools and workplaces

What role do healthcare systems play in managing population-level cholesterol? Effective cholesterol management at a population level requires coordinated efforts between healthcare providers, public health officials, and policymakers. Regular screening programs, coupled with accessible treatment options and lifestyle intervention support, are crucial components of a comprehensive approach to reducing the burden of high cholesterol and its associated cardiovascular risks.

The Economic Impact of High Cholesterol

The economic burden of high cholesterol extends beyond individual health costs. How does high cholesterol affect healthcare systems and economies? The direct and indirect costs associated with cardiovascular diseases, many of which are linked to high cholesterol, place significant strain on healthcare resources and productivity. This underscores the importance of preventive measures and early intervention in cholesterol management.

Cholesterol Testing in Special Populations

While general guidelines for cholesterol testing are widely applicable, certain populations may require special consideration. How does cholesterol testing differ for specific groups?

Pregnancy and Cholesterol Testing

Pregnancy naturally alters lipid metabolism, leading to increased cholesterol levels. How should cholesterol be monitored during pregnancy? While routine cholesterol screening is not typically recommended during pregnancy, women with pre-existing lipid disorders or those at high risk for cardiovascular complications may require careful monitoring and management throughout gestation.

Cholesterol Testing in Individuals with Chronic Diseases

Certain chronic conditions can significantly impact cholesterol levels and cardiovascular risk. How should cholesterol testing be approached in these cases?

• Diabetes: More frequent testing may be necessary due to the increased cardiovascular risk associated with diabetes.
• Chronic kidney disease: Lipid abnormalities are common, and specialized testing may be required to assess cardiovascular risk accurately.
• Thyroid disorders: Thyroid function can significantly affect lipid metabolism, necessitating careful interpretation of cholesterol test results.

What additional factors should healthcare providers consider when interpreting cholesterol results in these populations? The presence of comorbidities, medication effects, and overall disease management status all play crucial roles in accurately assessing cardiovascular risk and determining appropriate cholesterol management strategies.

The Future of Cholesterol Testing: Innovations and Technological Advancements

As technology continues to advance, new methods for cholesterol testing and cardiovascular risk assessment are emerging. What innovations are on the horizon for cholesterol testing?

• Point-of-care testing: Rapid, on-site cholesterol tests that provide immediate results
• Wearable devices: Continuous monitoring of various health parameters, including lipid levels
• Advanced imaging techniques: More detailed visualization of arterial plaque and cardiovascular health
• Artificial intelligence: Enhanced interpretation of cholesterol test results and risk prediction

How might these advancements change the landscape of cholesterol management? These innovations have the potential to make cholesterol testing more accessible, frequent, and integrated into daily life. This could lead to earlier detection of abnormalities and more personalized, timely interventions to manage cardiovascular risk.

The Role of Artificial Intelligence in Cholesterol Management

Artificial intelligence (AI) is poised to revolutionize many aspects of healthcare, including cholesterol management. How can AI contribute to more effective cholesterol testing and treatment? AI algorithms can analyze vast amounts of data, including genetic information, lifestyle factors, and comprehensive lipid profiles, to provide more accurate risk assessments and personalized treatment recommendations. This could lead to more precise and effective cholesterol management strategies tailored to individual patient needs.

As we look to the future, the field of cholesterol testing and management continues to evolve. With ongoing research, technological advancements, and a growing emphasis on personalized medicine, we can expect more sophisticated and effective approaches to maintaining cardiovascular health. Regular cholesterol testing remains a cornerstone of preventive healthcare, providing valuable insights that can guide individuals and healthcare providers in making informed decisions about heart health.

Get a Cholesterol Test | cdc.gov

From 2017 to 2020, 86.4 million U.S. adults age 20 or older had high or borderline high cholesterol (a total cholesterol level greater than or equal to 200 mg/dL).¹

From 2009 to 2016, about 1 in 5 adolescents had an unhealthy cholesterol measurement.²

Because high cholesterol doesn’t have symptoms, many people don’t know their levels are high.

The only way to know whether you have high cholesterol is to get your cholesterol checked. Your health care team can do a simple blood test, called a “lipid profile,” to measure your cholesterol levels.

Who needs to get their cholesterol checked and when?

Many people have never had their cholesterol checked, so they don’t know whether they are at risk.

Talk with your health care team about your health history and how often you need to have your cholesterol checked. Cholesterol should be checked starting early in life—even children and adolescents should have their cholesterol checked.

• Most healthy adults should have their cholesterol checked every 4 to 6 years.
• Some people, such as people who have heart disease, diabetes, or a family history of high cholesterol, need to get their cholesterol checked more often.
• Children and adolescents should have their cholesterol checked at least once between ages 9 and 11 and again between ages 17 and 21.²
• Children who have obesity or diabetes may need to be screened for high cholesterol more often.

The 2018 ACC/AHA Guidelines recommend that cholesterol management be based on a person’s lifetime cardiovascular risk, whether a person is 45 to 75 years of age, has diabetes, and has other factors.²  

Health care professionals calculate a person’s lifetime cardiovascular risk by considering

• any other health conditions the person may have at the same time (comorbidities)
• whether the person is being treated for high blood pressure
• whether the person smokes
• any other factors that may increase cardiovascular risk

Your cholesterol management and treatment decisions should be made in collaboration with a health care professional.

What happens during a cholesterol test?

The cholesterol test, or screening, requires a simple blood draw. The cholesterol test checks your levels of:

• Low-density lipoprotein (LDL) or “bad” cholesterol. Having high levels of LDL cholesterol can lead to plaque buildup in your arteries and result in heart disease or stroke.
• High-density lipoprotein (HDL) or “good” cholesterol. HDL is known as “good” cholesterol because high levels can lower your risk of heart disease and stroke.
• Triglycerides, a type of fat in your blood that your body uses for energy. The combination of high levels of triglycerides with low HDL cholesterol or high LDL cholesterol levels can increase your risk for heart attack and stroke.
• Total cholesterol, the total amount of cholesterol in your blood based on your HDL, LDL, and triglycerides numbers.

Learn more about LDL and HDL cholesterol and triglycerides.

What do I need to know before getting a cholesterol test?

You may need to fast (not eat or drink) for 8 to 12 hours before your cholesterol test. Be sure to ask your doctor how to prepare for the test.

How do blood cholesterol numbers affect me?

Your cholesterol numbers are important, but they are just part of your overall health. Learn more about what optimal blood cholesterol numbers are.

Your health care team will look at your cholesterol numbers, along with your family history, age, sex, and other parts of your lifestyle or health, such as smoking, that could increase your risk for high cholesterol.

Additionally, your health care team may order a coronary artery calcium (CAC) scan to help understand your risk and determine the best way to manage your cholesterol levels.²

This complete picture helps your health care team determine whether you should take steps, such as lifestyle changes or cholesterol-lowering medicine, to lower your risk for heart disease and stroke.

More Information

CDC

• About Heart Disease
• About Stroke
• Aortic Aneurysm
• About High Blood Pressure

Other organizations

• MedlinePlus: Cholesterol
• American Heart Association (AHA):
  • Cholesterol
  • What Your Cholesterol Levels Mean
• National Heart, Lung, and Blood Institute (NHLBI): High Blood Cholesterol—What You Need to Know

References

1. Tsao CW, Aday AW, Almarzooq ZI, Beaton AZ, Bittencourt MS, Boehme AK, et al. Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association. Circulation. 2023;147:e93–e621.
2. Perak AM, Ning H, Kit BK, et al. Trends in Levels of Lipids and Apolipoprotein B in US Youths Aged 6 to 19 Years, 1999-2016. JAMA. 2019;321(19):1895-1905.
3. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 ACC/AHA/AACVPR/AAPA/ ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2018;0:CIR.0000000000000625.

Cholesterol Levels: MedlinePlus Medical Test

What is a Cholesterol Test?

A cholesterol test is a blood test that measures the amount of cholesterol and certain fats in your blood. Cholesterol is a waxy, fat-like substance that’s found in your blood and every cell of your body. You need some cholesterol to keep your cells and organs healthy.

Your liver makes all the cholesterol your body needs. But you can also get cholesterol from the foods you eat, especially meat, eggs, poultry, and dairy products. Foods that are high in dietary fat can also make your liver produce more cholesterol.

There are two main types of cholesterol: low-density lipoprotein (LDL), or “bad” cholesterol, and high-density lipoprotein (HDL), or “good” cholesterol.

Too much LDL cholesterol in your blood increases your risk for coronary artery disease and other heart diseases. High LDL levels can cause the buildup of a sticky substance called plaque in your arteries. Over time, plaque can narrow your arteries or fully block them. When this happens, parts of your body don’t get enough blood:

• If the blood flow to the heart is blocked, it can cause a heart attack.
• If the blood flow to the brain is blocked, it can cause a stroke.
• If the blood flow to the arms or legs is blocked, it can cause peripheral artery disease.

Other names for a cholesterol test: Lipid profile, Lipid panel

What is it used for?

A cholesterol test gives you and your health care provider important information about your risk of developing heart disease. If your test shows you have high cholesterol, you can take steps to lower it. This may decrease your risk of developing heart problems in the future. A cholesterol test measures:

• LDL levels. Also known as the “bad” cholesterol, LDL is the main source of blockages in the arteries.
• HDL levels. Considered the “good” cholesterol, HDL helps get rid of “bad” LDL cholesterol.
• Total cholesterol. The combined amount of LDL cholesterol and HDL cholesterol in your blood.
• Triglyceride levels. Triglycerides are a type of fat found in your blood. Some studies show that high levels of triglycerides may increase the risk of heart disease, especially in women.
• VLDL levels. Very low-density lipoprotein (VLDL) is another type of “bad” cholesterol. High VLDL levels have been linked to plaque buildup in the arteries. VLDL isn’t usually included in routine cholesterol tests because it’s difficult to measure. About half of VLDL is triglycerides, so your VLDL level can be estimated as a percentage of your triglyceride level.

Why do I need a cholesterol test?

Your provider may order a cholesterol test as part of a routine exam. You may also have a cholesterol test if you have a family history of heart disease or if your risk for heart problems is high because of:

• High blood pressure
• Type 2 diabetes
• Smoking
• Excess weight or obesity
• Lack of physical activity
• A diet high in saturated fat

Your age may also be a factor, because your risk for heart disease increases as you get older.

What happens during a cholesterol test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

You may be able to use an at-home kit to check your cholesterol levels. Your kit will include a device to prick your finger to collect a drop of blood for testing. Be sure to follow the kit instructions carefully. Also, be sure to tell your provider if your at-home test shows that your total cholesterol level is higher than 200 mg/dl.

Will I need to do anything to prepare for the test?

You may need to fast (not eat or drink) for 9 to 12 hours before your blood cholesterol test. That’s why the tests are often done in the morning. Your provider will let you know if you need to fast and if there are any other special instructions.

Are there any risks to the test?

There is very little risk to having a blood test. You may experience slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

Cholesterol is usually measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. The information below will help you understand what your test results mean. In general, low LDL levels and high HDL cholesterol levels are good for heart health.

The LDL listed on your results may say “calculated.” This means that your LDL level is an estimate based on your total cholesterol, HDL, and triglycerides. Your LDL level may also be measured “directly” from your blood sample. Either way, you want your LDL number to be low.

A healthy cholesterol level for you may depend on your age, family history, lifestyle, and other risk factors for heart disease, such as high triglyceride levels. Your provider can explain what’s right for you.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about my cholesterol levels?

High cholesterol can lead to heart disease, the number one cause of death in the United States. You can’t change some risk factors for high cholesterol, such as age and your genes. But there are actions you can take to lower your LDL levels and reduce your risk, including:

• Eating a healthy diet. Reducing or avoiding foods high in saturated fat and cholesterol can help reduce the cholesterol levels in your blood.
• Losing weight. Being overweight can increase your cholesterol and risk for heart disease.
• Staying active. Regular exercise may help lower your LDL (bad) cholesterol levels and raise your HDL (good) cholesterol levels. It may also help you lose weight.

Talk to your provider before making any major change in your diet or exercise routine.

References

1. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. About Cholesterol; [last reviewed 2020 Nov 6; cited 2021 Dec 20]; [about 3 screens]. Available from: http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/About-Cholesterol_UCM_001220_Article.jsp
2. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. HDL (Good), LDL (Bad) Cholesterol and Triglycerides; [last reviewed 2020 Nov 6; cited 2021 Dec 20]; [about 3 screens]. Available from: http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/Good-vs-Bad-Cholesterol_UCM_305561_Article.jsp
3. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. How To Get Your Cholesterol Tested; [last reviewed: 2020 Nov 9; cited 2021 Dec 20]; [about 3 screens]. Available from: https://www.heart.org/en/health-topics/cholesterol/how-to-get-your-cholesterol-tested
4. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. Prevention and Treatment of High Cholesterol; [last reviewed 2020 Nov 11; cited 2021 Dec 20]; [about 7 screens]. Available from: http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Prevention-and-Treatment-of-High-Cholesterol_UCM_001215_Article.jsp
5. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. What Your Cholesterol Levels Mean; [last reviewed 2020 Nov 6; cited 2021 Dec 20]; [about 3 screens]. Available from: http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-Your-Cholesterol-Levels-Mean_UCM_305562_Article.jsp
6. FDA: US Food and Drug Administration [Internet]. Silver Spring (MD): U.S. Department of Health and Human Services; Cholesterol; [current as of 2018 Feb 4; cited 2019 Jan 25]; [about 4 screens]. Available from: https://www.fda.gov/medical-devices/home-use-tests/cholesterol
7. Healthfinder.gov. [Internet]. Washington D.C.: Office of Disease Prevention and Health Promotion; National Health Information Center; Get Your Cholesterol Checked; [updated 2021 Oct 7; cited 2021 Dec 20]; [about 7 screens]. Available from: https://health.gov/myhealthfinder/topics/doctor-visits/screening-tests/get-your-cholesterol-checked
8. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022. Cholesterol Test [cited 2021 Dec 20]; [about 3 screens]. Available from: https://www.mayoclinic.org/tests-procedures/cholesterol-test/about/pac-20384601
9. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022. High Cholesterol [cited 2021 Dec 20]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800
10. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022.VLDL cholesterol: Is it harmful? [cited 2021 Dec 20]; [about 3 screens]. Available from: http://www. mayoclinic.org/diseases-conditions/high-blood-cholesterol/expert-answers/vldl-cholesterol/faq-20058275
11. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; High Blood Cholesterol: What You Need to Know; 2001 May [revised 2005 Jun; cited 2017 Jan 26]; [about 6 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/all-publications-and-resources/high-blood-cholesterol-what-you-need-know
12. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Cholesterol: Diagnosis [cited 2021 Dec 20]; [about 20 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-cholesterol
13. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Cholesterol: Overview [cited 2021 Dec 20]; [about 4 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-cholesterol
14. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests: What Are the Risks of Blood Tests? [cited 2021 Dec 20]; [about 5 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
15. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests: What To Expect with Blood Tests; [cited 2017 Jan 25]; [about 1 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
16. Quest Diagnostics [Internet].Quest Diagnostics; c2000-2022. Test Summary: LDL Cholesterol; [reviewed 2020 Dec; cited 2021 Dec 20]; [about 3 screens]. Available from: https://testdirectory.questdiagnostics.com/test/test-guides/TS_LDL_Cholesterol/ldl-cholesterol?p=td

Total cholesterol

Total cholesterol (cholesterol) is a fat-like substance that the body needs for the normal functioning of cells, digestion of food, and the creation of many hormones. Too much cholesterol (cholesterol) increases the risk of plaque buildup in the arteries, which can block them and cause a heart attack or stroke.

Russian synonyms

Cholesterol, cholesterol

English synonyms

Blood cholesterol, Cholesterol, Chol, Cholesterol total.

Test method

Colorimetric photometric method.

Units

mmol/l (millimoles per litre).

What biomaterial can be used for research?

Venous, capillary blood.

How to properly prepare for an examination?

1. Do not eat for 12 hours before the test.
2. Exclude physical and emotional overexertion 30 minutes before the study.
3. Do not smoke for 30 minutes before the test.

General information about the study

Cholesterol (ChS, cholesterol) is a fat-like substance that is vital for the body. The correct scientific name for this substance is “cholesterol” (the ending “-ol” indicates belonging to alcohols), however, the name “cholesterol” has become widespread in the mass literature, which we will use later in this article. Cholesterol is involved in the formation of cell membranes of all organs and tissues of the body. Based on cholesterol, hormones are created that are involved in the growth, development of the body and the implementation of the reproduction function. Bile acids are formed from cholesterol, which are part of bile, thanks to which fats are absorbed in the intestines.

Cholesterol is insoluble in water, therefore, in order to move around the body, it is “packed” into a protein shell, consisting of special proteins – apolipoproteins. The resulting complex (cholesterol + apolipoprotein) is called lipoprotein. Several types of lipoproteins circulate in the blood, differing in the proportions of their components:

• very low density lipoproteins (VLDL),
• low density lipoproteins (LDL),
• high density lipoproteins (HDL).

LDL-C and VLDL-C are considered “bad” types of cholesterol, as they contribute to the formation of plaque in the arteries, while HDL-C, on the contrary, is called “good”, since excess amounts of cholesterol are removed by HDL.

The total cholesterol (cholesterol) test measures the total amount of cholesterol (both “bad” and “good”) circulating in the blood as lipoproteins.

The liver produces enough cholesterol for the needs of the body, but part of it comes from food, mainly meat and fatty dairy products. If a person has a genetic predisposition to high cholesterol or eats too much cholesterol-containing food, then the level of cholesterol in the blood can rise and cause harm to the body. Excess amounts of cholesterol are deposited in the walls of blood vessels in the form of plaques, which can restrict the movement of blood through the vessel, and also make the vessels more rigid (atherosclerosis), which significantly increases the risk of heart disease (ischemic disease, heart attack) and stroke.

What is research used for?

• To assess the risk of atherosclerosis and heart problems.
• For the prevention of many diseases.

When is the test ordered?

• At least every 5 years for all adults over 20 years of age (usually part of the routine screening test).
• Together with analyzes for LDL-C, VLDL-C, HDL-C, triglycerides and with the atherogenic coefficient – this is the so-called lipid profile.
• Several times a year if a diet with restricted animal fats and/or cholesterol-lowering medications is prescribed (to check if the person is reaching their target cholesterol level and therefore reducing the risk of cardiovascular disease).
• If one or more risk factors for cardiovascular disease are present in the patient’s lifetime:
  • smoking,
  • certain age period (men over 45, women over 55),
  • high blood pressure (140/90 mmHg and above),
  • elevated cholesterol or cardiovascular disease in other family members (heart attack or stroke in a male relative under 55 years of age or female under 65 years of age),
  • ischemic heart disease,
  • past myocardial infarction or stroke,
  • diabetes mellitus,
  • overweight,
  • alcohol abuse,
  • intake of large amounts of food containing animal fats,
  • low physical activity.
• At 2-10 years of age, a child in whose family someone had heart disease at a young age or high cholesterol.

What do the results mean?

Reference values ​​(cholesterol norm):

The concept of “norm” is not fully applicable in relation to the level of total cholesterol. For different people with a different number of risk factors, the norm of cholesterol will be different. The test for total cholesterol (cholesterol) is used to determine the risk of cardiovascular disease, however, in order to determine this risk for an individual patient most accurately, it is necessary to evaluate all predisposing factors.

According to clinical guidelines, ¹ individual risk is calculated using the Systematic Coronary Risk Evaluation (SCORE) scale.

“Diagnostics and correction of lipid metabolism disorders for the prevention and treatment of atherosclerosis. Russian guidelines, VII revision. 2020″.

“2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk”.

Causes of increased total cholesterol (hypercholesterolemia)

Hypercholesterolemia may be the result of a hereditary predisposition (familial hypercholesterolemia) or excessive dietary intake of animal fats. Most people with high cholesterol have some degree of both.

Cholesterol is only one of the risk factors for cardiovascular disease. The overall assessment of this risk is carried out taking into account all parameters, including the presence of cardiovascular diseases in the patient or his relatives, smoking, high blood pressure, diabetes, obesity, etc. For patients who have these factors, the target levels of total cholesterol are less 4 mmol/l. To more accurately determine the risk of cardiovascular disease, a test for low-density lipoprotein cholesterol (LDL cholesterol) is prescribed.

Before prescribing treatment, it is necessary to exclude other causes of increased total cholesterol:

1. cholestasis – bile stasis, which can be caused by liver disease (hepatitis, cirrhosis) or gallstones,
2. chronic inflammation of the kidneys leading to nephrotic syndrome,
3. chronic renal failure,
4. decreased thyroid function (hypothyroidism),
5. poorly treated diabetes mellitus,
6. alcoholism,
7. obesity,
8. cancer of the prostate or pancreas.

Reasons for lowering the level of total cholesterol (hypocholesterolemia)

• Heredity.
• Severe liver disease.
• Oncological diseases of the bone marrow.
• Increased thyroid function (hyperthyroidism).
• Intestinal malabsorption.
• Folic or B ₁₂ – deficiency anemia.
• Generalized burns.
• Tuberculosis.
• Acute diseases, acute infections.
• Chronic obstructive pulmonary disease.

What can influence the result?

Cholesterol concentration may change from time to time, this is normal. A single measurement does not always reflect the usual level, so it may sometimes be necessary to retake the analysis after 1-3 months.

Raise total cholesterol:

• pregnancy (cholesterol test should be taken at least 6 weeks after delivery),
• long fast,
• blood donation in standing position,
• anabolic steroids, androgens, corticosteroids,
• smoking,
• ingestion of food containing animal fats.

Reduces total cholesterol:

• blood donation in the supine position,
• allopurinol, clofibrate, colchicine, antifungals, statins, cholestyramine, erythromycin, estrogens,
• intense physical activity,
• diet high in polyunsaturated fatty acids.

Important notes

• Cholesterol testing should be done when the person is relatively healthy. After an acute illness, heart attack, surgery, you should wait at least 6 weeks before measuring cholesterol.
• In the USA, cholesterol is measured in milligrams per deciliter, in Russia and Europe – in millimoles per liter. The conversion is carried out according to the formula: cholesterol (mg / dl) \u003d cholesterol (mmol / l) × 88.5 or cholesterol (mmol / l) \u003d cholesterol (mg / dl) x 0.0113.

Also recommended

• Triglycerides
• Cholesterol – high density lipoprotein (HDL)
• Cholesterol – low density lipoprotein (LDL)
• Atherogenic index
• Apolipoprotein A1
• Apolipoprotein B

Who orders the examination?

General practitioner, internist, cardiologist.

Cholesterol Levels – Understand the Test & Your Results

Accordion Title

• What is a cholesterol test?

  Analysis
  cholesterol – a blood test that measures the amount of cholesterol and certain fats in your blood. Cholesterol is a waxy, fat-like substance found in your blood and every cell in your body. For your cells and organs to be healthy, they must contain a certain amount of cholesterol.

  Your liver makes all the cholesterol your body needs. But you can also get cholesterol from the foods you eat, such as meat, eggs, poultry, and dairy products. Foods high in
  Dietary fat can also cause the liver to produce more cholesterol.

  There are two main types of cholesterol:
  low-density lipoprotein (LDL) or “bad” cholesterol, and
  high-density lipoprotein (HDL) or “good” cholesterol.

  Elevated blood LDL levels increase the risk
  coronary heart disease and others
  heart diseases. Elevated levels of DPNP can lead to a buildup of a viscous substance, or plaque, in your arteries. Gradually, the plaque will narrow the lumen of the arteries or completely block it. In this case, different parts of your body will not receive sufficient blood flow:

  • If blood flow to the heart is cut off,
    myocardial infarction.
  • If blood flow to the brain is cut off,
    stroke .
  • If blood flow to the arms or legs is cut off,
    damage to the peripheral arteries.

  Other names for cholesterol test: Lipid profile, lipidogram

• What is it used for?

  A cholesterol test gives you and your healthcare provider important information about your risk of developing heart disease. If your cholesterol is high, you can take steps to lower it. This may lead to a reduced risk of developing heart disease in the future. Analysis for cholesterol determines:

  • LDL levels. LDL is also called “bad” cholesterol, as it is the main source of blockage in the arteries.
  • HDL levels. HDL is considered “good” cholesterol and helps to get rid of “bad” LDL cholesterol.
  • Total cholesterol. The combined amount of LDL cholesterol and HDL cholesterol in the blood.
  • Triglyceride levels. Triglycerides are a type of fat in the blood. Some research suggests that high triglyceride levels may increase the risk of heart disease, especially in women.
  • 
    VLDL levels. Very low density lipoprotein (VLDL) is another type of “bad” cholesterol. High levels of VLDL have been linked to plaque formation in the arteries. VLDL is usually not included in routine cholesterol tests because it is difficult to detect. About half of your VLDL is triglycerides, so your VLDL can be estimated as a fraction of your triglycerides.

• Why do I need a cholesterol test?

  Your provider may order a cholesterol test as part of a routine checkup. You may also be tested for cholesterol if you have a family history of heart disease or if you are at increased risk for heart problems for the following reasons:

  • High blood pressure
  • Diabetes mellitus
    2 types
  • Smoking
  • Overweight or
    obesity
  • Lack of physical activity
  • A diet rich in saturated fats

  Your age may also play a role, as your risk of heart disease increases with age.

• What happens when you take a cholesterol test?

  Your health care provider will draw blood from a vein in your arm using a small needle. After inserting the needle, the test tube is filled with a small amount of blood. You may feel a slight prick as the needle is inserted or withdrawn. This usually takes less than five minutes.

  You can also use
  home kit to check your cholesterol levels. The kit includes a finger prick device to take a drop of blood for analysis. Follow the instructions for using the kit. Be sure to tell your provider if your home test shows a total cholesterol level above 200 mg/dl.

• How do I prepare for the test?

  You may be asked
  do not eat or drink anything for 9-12 hours before a blood test for cholesterol. Therefore, tests are often taken in the morning. Your provider will tell you to come on an empty stomach or follow any special instructions.

• Are there any risks associated with taking the test?

  Blood testing carries few risks. You may feel some pain where the needle was inserted. In addition, bruising may form at this site, but most symptoms resolve quickly.

• What do the results mean?

  Cholesterol is usually measured in milligrams (mg) of cholesterol per deciliter (dl) of blood. The information below will help you understand what your analysis results mean. In general, low LDL levels and high HDL levels are good for heart health.

  The LDL result can be labeled as “estimated”. This means that your LDL is an estimate based on total cholesterol, HDL and triglycerides. Your LDL level can also be measured directly in a blood sample. In any case, it is desirable to have a low level of LDL.

  Healthy cholesterol levels for you depend on your age, family history, lifestyle, and other risk factors for heart disease, such as high triglyceride levels. Your supplier can explain what is right for you.

  Find out more
  about laboratory tests, reference ranges, and how to interpret results.

• Is there anything else I need to know about my cholesterol levels?

  High cholesterol can lead to heart disease, which is the number one cause of death in the United States. You cannot control some of the risk factors that cause high cholesterol, such as age or genetics. But you can take steps to lower your LDL levels and your risk, including:

  • 
    Eat properly . Reduce or eliminate foods high in saturated fat and cholesterol, which may lower blood cholesterol levels.
  • 
    Lose weight. Being overweight can increase cholesterol and the risk of heart disease.
  • 
    Maintain an active lifestyle. Regular exercise can help lower LDL (bad cholesterol) levels and raise HDL (good cholesterol) levels. They can also help you lose weight.

  Talk to your provider about any major changes you make to your diet or exercise routine before you implement them.

• References

  1. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. About Cholesterol; [last reviewed 2020 Nov 6; cited 2021 Dec 20]; [about 3 screens]. Available from:
     http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/About-Cholesterol_UCM_001220_Article.jsp
  2. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc. ; c2022. HDL (Good), LDL (Bad) Cholesterol and Triglycerides; [last reviewed 2020 Nov 6; cited 2021 Dec 20]; [about 3 screens]. Available from:
     http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/Good-vs-Bad-Cholesterol_UCM_305561_Article.jsp
  3. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. How To Get Your Cholesterol Tested; [last reviewed: 2020 Nov 9; cited 2021 Dec 20]; [about 3 screens]. Available from:
     https://www.heart.org/en/health-topics/cholesterol/how-to-get-your-cholesterol-tested
  4. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. Prevention and Treatment of High Cholesterol; [last reviewed 2020 Nov 11; cited 2021 Dec 20]; [about 7 screens]. Available from:
     http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Prevention-and-Treatment-of-High-Cholesterol_UCM_001215_Article.jsp
  5. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. What Your Cholesterol Levels Mean; [last reviewed 2020 Nov 6; cited 2021 Dec 20]; [about 3 screens]. Available from:
     http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-Your-Cholesterol-Levels-Mean_UCM_305562_Article.jsp
  6. FDA: US Food and Drug Administration [Internet]. Silver Spring (MD): U.S. Department of Health and Human Services; cholesterol; [current as of 2018 Feb 4; cited 2019Jan 25]; [about 4 screens]. Available from:
     https://www.fda.gov/medical-devices/home-use-tests/cholesterol
  7. Healthfinder.gov. [Internet]. Washington D.C.: Office of Disease Prevention and Health Promotion; National Health Information Center; Get Your Cholesterol Checked; [updated 2021 Oct 7; cited 2021 Dec 20]; [about 7 screens]. Available from:
     https://health.gov/myhealthfinder/topics/doctor-visits/screening-tests/get-your-cholesterol-checked
  8. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022. Cholesterol Test [cited 2021 Dec 20]; [about 3 screens]. Available from:
     https://www.mayoclinic.org/tests-procedures/cholesterol-test/about/pac-20384601
  9. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022. High Cholesterol [cited 2021 Dec 20]; [about 3 screens]. Available from:
     https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800
  10. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022.VLDL cholesterol: Is it harmful? [cited 2021 Dec 20]; [about 3 screens]. Available from:
      http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/expert-answers/vldl-cholesterol/faq-20058275
  11. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; High Blood Cholesterol: What You Need to Know; 2001 May [revised 2005 Jun; cited 2017 Jan 26]; [about 6 screens]. Available from:
      https://www. nhlbi.nih.gov/health-topics/all-publications-and-resources/high-blood-cholesterol-what-you-need-know
  12. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Cholesterol: Diagnosis [cited 2021 Dec 20]; [about 20 screens]. Available from:
      https://www.nhlbi.nih.gov/health-topics/blood-cholesterol
  13. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Cholesterol: Overview [cited 2021 Dec 20]; [about 4 screens]. Available from:
      https://www.nhlbi.nih.gov/health-topics/blood-cholesterol
  14. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests: What Are the Risks of Blood Tests? [cited 2021 Dec 20]; [about 5 screens]. Available from:
      https://www.nhlbi.nih.gov/health-topics/blood-tests
  15. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.