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High cholesterol

How do doctors diagnose high cholesterol?

Your doctor may offer you a cholesterol test as part of a general check on your health. Or you may be advised to have your cholesterol checked because you have other risk factors for heart disease, such as high blood pressure, and your doctor wants to know what kind of treatment you need. All that's needed is a simple blood test.

When doctors take a blood sample to check your cholesterol level they don't just measure the amount of cholesterol in your blood. They measure the different types of cholesterol in your blood and also the amount of triglycerides. This type of test is called a lipid profile. Lipids is the name given to fats in your blood.

For more information, see More about cholesterol and triglycerides.

How your doctor takes a lipid profile

You'll usually be asked not to eat for nine hours to 12 hours before you have a lipid profile so that all your food has had time to be digested and won't affect the test. This is because after a meal the level of triglycerides in your blood is higher than normal. This type of test is called a fasting lipid (or lipoprotein) profile.

All that's needed for a lipid profile is a blood sample. This can be taken from a vein either on the inside of your elbow or from the back of your hand. To take this sample, your doctor or nurse usually places a type of elastic band, called a tourniquet, around your upper arm to make it easier to collect the blood.

The doctor then inserts a needle into your vein and collects your blood in the syringe or in a small glass tube. You may feel a slight pinch when the needle pierces your skin, but this won't last.

After your blood is taken, it is sent off to a laboratory where the lipids in it are measured.

The lipid profile gives you four readings, or numbers. Your doctor may call these your "cholesterol numbers."

These numbers are levels of:

Total cholesterol (the amount of bad LDL cholesterol plus the good HDL cholesterol circulating in your blood)
LDL cholesterol (the bad cholesterol that clogs up blood vessels)
HDL cholesterol (the good cholesterol that picks up any extra cholesterol in your blood vessels)
Triglycerides (bad lipids).

What the numbers mean

The levels of lipids in your blood are measured in milligrams per deciliter of blood, or mg/dL for short.

Source:
American Heart Association.
What are healthy levels of cholesterol?
Available at http://www.americanheart.org/presenter.jhtml?identifier=183 (accessed on 21 September 2006).

Source:
Grundy SM, Cleeman JI, Merz NB, et al.
Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines.
Circulation. 2004; 110: 227-239.

	Numbers	What the numbers mean for adults
Total cholesterol	Less than 200 mg/dl	This is what you should aim for. If your total cholesterol is less than 200 mg/dl you have less of a chance of having a heart attack or a stroke.
	200 mg/dl to 239 mg/dL	This is a borderline number. It means that your cholesterol needs attention.
	240 mg/dl or above	This is high cholesterol. Your risk of heart disease is more than two times higher than someone whose cholesterol is below 200 mg/dl.
LDL (bad) cholesterol	Less than 100 mg/dl	This is what you should aim for, especially if you already have heart disease or diabetes. In fact, your doctor may even want your LDL cholesterol level to be lower than 70 mg/dl if you have lots of risk factors for heart attack or stroke.
	100 mg/dl to 129 mg/dl	This is probably fine if you don't have any other risk factors for heart disease, but it is high if you have heart disease or diabetes.
	130 mg/dl to 159 mg/dl	This is a borderline number. Your cholesterol may need attention.
	160 mg/dl to 189 mg/dl	This is high. Your risk of heart disease is increased.
	190 mg/dl and above	This is very high. Your risk of heart disease is very much increased.
HDL (good) cholesterol	Less than 40 mg/dl	Your risk of heart disease is increased.
	40 mg/dl to 59 mg/dl	Slightly better. Your chances of heart disease fall as your HDL levels rise.
	60 mg/dl and above	Protects against heart disease.
Triglycerides	Less than 150 mg/dl	Normal.
	150 to 199 mg/dl	These numbers are borderline to high.
	200 to 499 mg/dl	High. Your risk of heart disease is increased, especially if you have low HDL cholesterol or high LDL cholesterol.
	500 mg/dl and above	Very high. Your risk of heart disease is very much increased, especially if you have low HDL cholesterol or high LDL cholesterol.

The numbers mean different things for children.

	Numbers	What the numbers mean for children
Total cholesterol	Less than 170 mg/dl	Healthy
	170 mg/dl to 199 mg/dl	Heading toward unhealthy
	More than 200 mg/dl	Unhealthy
LDL (bad) cholesterol	Less than 110 mg/dl	Healthy
	110 mg/dl to 129 mg/dl	Heading toward unhealthy
	More than 130 mg/dl	Unhealthy

Sources for the information on this page:

American Heart Association.What are healthy levels of cholesterol?Available at http://www.americanheart.org/presenter.jhtml?identifier=183 (accessed on 21 September 2006).

Grundy SM, Cleeman JI, Merz NB, et al.Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines.Circulation. 2004; 110: 227-239.

This information was last updated on Nov 06, 2008

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