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Cholesterol test facts
- Cholesterol is a naturally occurring substance in the body that is an important part of normal body function.
- Cholesterol has two main types: HDL, or good cholesterol, that protects against heart disease, stroke and peripheral vascular disease; and LD, or bad, cholesterol, which increases the risk of these conditions.
- Cholesterol tests measure total cholesterol as well as HDL and LDL levels in the blood. Triglycerides, another type of fat present in the bloodstream, may also be measured.
- Cholesterol tests are usually ordered and blood drawn in a doctor's office. There are also home test kits available. It is important to be fasting for the tests to be accurate. Typically, a fasting test is performed first thing in the morning before the individual has eaten anything for the day. Fasting typically requires 12 hours without food. Water, plain tea or coffee are permitted, and hydration is required. No other liquids are acceptable during the fasting period. Patients cannot add sugar, artificial sweeteners, cream, or milk to drinks.
- If you take OTC, prescription, or herbal supplements discuss these with your doctor prior to the test.
- Cholesterol test results should be discussed with the health-care professional to determine if treatment of high cholesterol is necessary to decrease the risk of heart disease and stroke.
What is cholesterol?
Cholesterol is a naturally occurring fat that the body needs to produce important structures and chemicals. It is one of the main components of cell membranes, the outer lining that protects the internal structures that make body cells work and function properly. Cholesterol is also a building block for many of the hormones in the body including mineralocorticoids that control electrolyte levels in the body, glucocorticoids involved in carbohydrate metabolism, and sex hormones including testosterone, estrogen, and progesterone. Cholesterol is one of the building blocks that assists in forming vitamin D in the body. Vitamin D is responsible for calcium metabolism in the body.
There are two important types of cholesterol, high density lipoprotein (HDL) and low density lipoprotein (LDL). LDL is the bad cholesterol that deposits in arteries when too much is present. HDL is considered the good cholesterol because it can bind to LDL cholesterol and return it to the liver where it can be removed from the body.
While most of the cholesterol in the body is obtained through the foods we eat, it is also produced in the liver to meet the body's demands. The body attempts to regulate the amount of total cholesterol, but when too much cholesterol is present, the excess can be deposited in arteries throughout the body. This leads to artery narrowing and increases the risk of heart attack, stroke, and peripheral vascular disease. Elevated LDL levels increase the risk of these diseases, and elevated HDL levels decrease the risk.
Quick GuideCholesterol Levels: What the Numbers Mean
What does a cholesterol test measure?
Cholesterol tests are blood tests that measure the amount of cholesterol in the body. The health-care professional may order only a cholesterol test with results showing:
- The total cholesterol,
- HDL, and
- LDL levels.
In addition to cholesterol level, the health-care professional also may order a lipid profile test. The lipid profile test will also measure triglyceride levels and another fatty substance found in the blood.
How do I prepare for a cholesterol test?
For the best and most accurate results, it is important to fast for many hours before the cholesterol blood test is taken. Each laboratory has its own guidelines for not eating, and the fast may range from 9-16 hours. It is acceptable to drink water.
Do I need to call my doctor for my test results?
It usually takes a day or two from the time the blood is drawn until your health-care professional receives the results of the cholesterol test. Ideally, the health-care professional will contact you with those results and explain their significance. However, if you have not been contacted in a short period of time, it is reasonable to contact your health-care professional and ask for the test results.
There are home cholesterol test kits available that have been U.S. FDA approved, but their accuracy is not necessarily as good as that of a certified laboratory. These tests usually measure total cholesterol only, but some also can measure HDL, LDL and cholesterol. If you use one of the home kits, it is wise to discuss the results with your health-care professional.
The purpose of the cholesterol blood test is to determine whether treatment is needed for high cholesterol. That treatment may include dietary and lifestyle modifications, medications, or both to control cholesterol levels and decrease the risk of heart disease, stroke, and peripheral vascular disease.
How do I interpret my cholesterol test results?
Cholesterol levels are but one of the risk factors for heart disease, stroke, and peripheral vascular disease. It is important to control cholesterol levels to minimize risk just as it is important to control diabetes, high blood pressure, and avoid smoking.
Guidelines for cholesterol levels have been developed by many health organizations including the American Heart Association. It is important to remember that tests may need to be repeated over time to help monitor treatment and disease risk prevention.
|Less than 200 mg/dL: desirable|
|200-239 mg/dL: borderline high risk|
|240 and over: high risk|
|HDL (high density lipoprotein)|
|Less than 40 mg/dL (men), less than 50 mg/dL (women): increased risk of heart disease|
|Greater than 60mg/dL: some protection against heart disease|
|LDL (low density lipoprotein)|
|Less than 100 mg/dL: optimal|
|100-129 mg/dL: near optimal/above optimal|
|130-159 mg/dL: borderline high|
|160- 189 mg/dL: high|
|190 mg/dL and above: very high|
|Less than n150 mg/dL: normal|
|150-199 mg/dL: borderline to high|
|Above 500 mg/dL: very high|
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HDL vs. LDL Cholesterol Differences
HDL (high-density lipoprotein), or the "good" cholesterol, and LDL (low-density lipoprotein), or the "bad" cholesterol, are lipoproteins that carry cholesterol through the veins and arteries of the body. HDL and LDL combined, is your "total" blood cholesterol. The difference between the two are that high levels of the "good," or HDL cholesterol, may protect against narrowing of the blood vessels in the body, which protects you against heart attack, stroke, and other cardiovascular diseases. But high levels of LDL, or the "bad" cholesterol, may worsen the narrowing of the blood vessels in the body, which puts you at a greater risk of stroke, heart attack, and cardiovascular diseases, some of which are life threatening.
Triglycerides are found in body fat and from the fats you eat. Triglycerides levels in the blood reflect what you have eaten recently. HDL and LDL cholesterol levels show what you have been eating over a long period of time. If you eat a fatty meal your triglyceride levels will be elevated for a short period of time. If you continue to eat a diet high in fat your triglyceride levels will continue to rise. The liver transfers the triglycerides into body fat, or cholesterol, which raises LDL and lowers HDL levels in the blood.
Healthy (normal) total blood cholesterol levels are determined by the levels of HDL, LDL, and triglycerides in the blood. Talk with your doctor or other health care professional if you are concerned about your cholesterol levels, which can easily be determined with a simple blood test.
VLDL, or very-low- lipoproteins, is a third type of cholesterol. VLDL is another type of "bad" cholesterol that the liver produces, which contains a high amount of triglycerides.
REFERENCE: American Heart Association. "HDL (Good), LDL (Bad) Cholesterol and Triglycerides." Updated: Jul 05, 2017.
Heart Attack Symptoms and Early Warning SignsRecognizing heart attack symptoms and signs can help save your life or that of someone you love. Some heart attack symptoms, including left arm pain and chest pain, are well known but other, more nonspecific symptoms may be associated with a heart attack. Nausea, vomiting, malaise, indigestion, sweating, shortness of breath, and fatigue may signal a heart attack. Heart attack symptoms and signs in women may differ from those in men.
Heart Disease (Coronary Artery Disease)
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include:
- High blood pressure
- High cholesterol
- Family history
Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Cholesterol QuizHigh cholesterol can be a dangerous condition. Take the Cholesterol Quiz to understand what high cholesterol means in terms of your health risks.
High Triglycerides FoodsHigh triglycerides increase the risk of heart disease. Lower triglyceride levels and reduce cholesterol by eating foods that promote heart health. Reduce your intake of fat and sugar and do not eat excess calories. Get adequate nutrition by eating fruit, vegetables, whole grains, and lean meats.
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Peripheral Vascular Disease
Peripheral vascular disease (PVD) refers to diseases of the blood vessels (arteries and veins) located outside the heart and brain. While there are many causes of peripheral vascular disease, doctors commonly use the term peripheral vascular disease to refer to peripheral artery disease (peripheral arterial disease, PAD), a condition that develops when the arteries that supply blood to the internal organs, arms, and legs become completely or partially blocked as a result of atherosclerosis. Peripheral artery disease symptoms include intermittent leg pain while walking, leg pain at rest, numbness in the legs or feet, and poor wound healing in the legs or feet.
Treatment for peripheral artery disease include lifestyle measures, medication, angioplasty, and surgery.
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Stroke Symptoms and Treatment
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include
- double vision or vision loss,
- vertigo, and
- difficulty speaking or understanding speech.
A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
Symptoms of Serious Diseases and Health ProblemsLearn how to recognize early warning signs and symptoms of serious diseases and health problems, for example, chronic cough, headache, chest pain, nausea, stool color or consistency changes, heartburn, skin moles, anxiety, nightmares, suicidal thoughts, hallucinations, delusions, lightheadedness, night sweats, eye problems, confusion, depression, severe pelvic or abdominal pain, unusual vaginal discharge, and nipple changes.
The symptoms and signs of serious health problems can be caused by strokes, heart attacks, cancers, reproductive problems in females (for example, cancers, fibroids, endometriosis, ovarian cysts, and sexually transmitted diseases or STDs), breast problems (for example, breast cancer and non-cancer related diseases), lung diseases (for example, chronic obstructive pulmonary disease or COPD, lung cancer, emphysema, and asthma), stomach or digestive diseases (for example, cancers, gallbladder, liver, and pancreatic diseases, ulcerative colitis, or Crohn's disease), bladder problems (for example, urinary incontinence, and kidney infections), skin cancer, muscle and joint problems, emotional problems or mental illness (for example, postpartum depression, major depression, post-traumatic stress disorder (PTSD), mania, and schizophrenia), and headache disorders (for example, migraines, or "the worst headache of your life), and eating disorders and weight problems (for example, anorexia or bulimia).
Triglyceride TestTriglycerides are a common form of fat that we digest. Triglycerides are the main ingredient in animal fats and vegetable oils. Elevated levels of triglycerides are a risk factor for heart disease, heart attack, stroke, fatty liver disease, and pancreatitis. Elevated levels of triglycerides are also associated with diseases like diabetes, kidney disease, and medications (for example, diuretics, birth control pills, and beta blockers). Dietary changes, and medication if necessary can help lower triglyceride blood levels.
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