Understanding Your Cholesterol Test Results
Your health care provider may send you for cholesterol tests, either as a part of a standard check-up or because he or she suspects you may be at risk for developing heart disease. But do you know what the cholesterol test results actually mean? Read on to learn how to interpret the numbers.
Why Do I Need a Cholesterol Test?
Cholesterol is a waxy, fat-like substance. Your liver makes all the cholesterol your body needs. But you take in more cholesterol from certain foods, such as those from animals. If you have too much cholesterol in your body, it can build up in the walls of your arteries (as "plaque") and eventually harden. This process, called atherosclerosis, actually narrows the arteries, making it harder for blood to travel through the vessels.
Unfortunately, high cholesterol doesn't cause symptoms. In later stages of atherosclerosis, though, you may suffer angina -- severe chest pain from lack of blood flow to the heart. If an artery gets totally blocked, a heart attack results. A routine blood cholesterol test is a far better way of finding out what your cholesterol level is.
What Does a Cholesterol Test Measure?
In addition to measuring the total cholesterol in your blood, the standard cholesterol test (called a "lipid panel") measures three specific kinds of fat:
Low-density lipoproteins (LDL). This is the "bad cholesterol," the main cause of plaque build-up, which increases your risk for heart disease. In general, the lower the number, the better. But LDL cholesterol is only one part of a larger equation that measures a person's overall risk of having a heart attack or stroke. For years, guidelines focused on specific target numbers for individuals to achieve to lower their risk. The most recent guidelines focus on a person's overall risk and, based on that risk, recommend a certain percentage of LDL reduction as one part of a strategy for preventing serious heart and vascular problems.
High-density lipoproteins (HDL). This is the "good cholesterol." It transports bad cholesterol from the blood to the liver, where it is excreted by the body. Your HDL is another part of the equation that identifies the risk of a cardiovascular event. In general, the higher the number the better, although, as with LDL, the emphasis has shifted from specific target numbers to strategies for reducing the overall risk.
Triglycerides. Another type of fat in the bloodstream, triglycerides are also linked to heart disease. They are stored in fat cells throughout the body.
What Do Cholesterol Test Numbers Mean?
If you have a lipoprotein profile, it's important to look at all the numbers from the cholesterol test, not just the total cholesterol number. That's because LDL and HDL levels are two primary indicators of potential heart disease. Use the information below to interpret your results (with the help of your doctor, of course). This will help you get a better idea about your risk for heart disease.
Total blood cholesterol level:
High risk: 240 mg/dL and above
Borderline high risk: 200-239 mg/dL
Desirable: Less than 200 mg/dL
LDL cholesterol levels:
190 mg/dL and above represents a high risk for heart disease and is a strong indicator that the individual can benefit from intensive treatment, including life style changes, diet, and statin therapy for reducing that risk.
For LDL levels that are equal to or less than 189 mg/dL, the guidelines recommend strategies for lowering LDL by 30% to 50% depending on what other risk factors you have that can affect the health of your heart and blood vessels.
High risk: Less than 40 mg/dL for men and less than 50 mg/dL for women
Very high risk: 500 mg/dL and above
High risk: 200-499 mg/dL
Borderline high risk: 150-199 mg/dL
Normal: Less than 150 mg/dL
How Do I Prepare for My Cholesterol Test?
If your doctor recommends a "non-fasting" cholesterol test, the lab will look only at your total cholesterol (and sometimes your HDL) numbers. For that test, you merely need to show up at the lab and have some blood drawn. If your doctor suggests a "fasting" cholesterol test (also called a "lipid profile"), the lab will analyze your levels of LDL, HDL, triglycerides, and total cholesterol. For that test, you will need to fast nine to 12 hours before the blood test.
Sometimes a doctor will ask you to do a non-fasting cholesterol test first. Depending on the results, he or she may then send you back for the more complete lipid profile.
How Will My Doctor Use Results From My Cholesterol Test?
After reviewing your blood test, The doctor will also consider other risk factors you might have for heart disease, including:
Your family history
Blood pressure and whether or not you're being treated for high blood pressure
History of diabetes
Evidence of elevated blood sugars
Then, your doctor will talk with you about your level of risk and the potential benefit to be derived by taking steps that include changes in your level of activity and diet as well as using medication to improve your cholesterol levels in order to reduce your overall risk.
How Often Should I Have A Cholesterol Test?
The National Cholesterol Education Program recommends adults age 20 years or older have a cholesterol test every five years. People who are at risk for heart attack or heart disease or who have a family history of either should be checked more often.
A complete cholesterol test — also called a lipid panel or lipid profile — is a blood test that can measure the amount of cholesterol and triglycerides in your blood.
A cholesterol test can help determine your risk of the buildup of plaques in your arteries that can lead to narrowed or blocked arteries throughout your body (atherosclerosis).
A cholesterol test is an important tool. High cholesterol levels often are a significant risk factor for coronary artery disease.
Why it's done
High cholesterol usually causes no signs or symptoms. A complete cholesterol test is done to determine whether your cholesterol is high and estimate your risk of developing heart attacks and other forms of heart disease and diseases of the blood vessels.
A complete cholesterol test includes the calculation of four types of fats (lipids) in your blood:
Total cholesterol. This is a sum of your blood's cholesterol content.
High-density lipoprotein (HDL) cholesterol. This is called the "good" cholesterol because it helps carry away LDL cholesterol, thus keeping arteries open and your blood flowing more freely.
Low-density lipoprotein (LDL) cholesterol. This is called the "bad" cholesterol. Too much of it in your blood causes the buildup of fatty deposits (plaques) in your arteries (atherosclerosis), which reduces blood flow. These plaques sometimes rupture and can lead to a heart attack or stroke.
Triglycerides. Triglycerides are a type of fat in the blood. When you eat, your body converts calories it doesn't need into triglycerides, which are stored in fat cells. High triglyceride levels are associated with several factors, including being overweight, eating too many sweets or drinking too much alcohol, smoking, being sedentary, or having diabetes with elevated blood sugar levels.
Who should get a cholesterol test?
Adults at average risk of developing coronary artery disease should have their cholesterol checked every five years, beginning at age 18.
More-frequent testing might be needed if your initial test results were abnormal or if you already have coronary artery disease, you're taking cholesterol-lowering medications, or you're at higher risk of coronary artery disease because you:
Have a family history of high cholesterol or heart attacks
Are physically inactive
Eat an unhealthy diet
Are a man older than 45 or a woman older than 55
People with a history of heart attacks or strokes require regular cholesterol testing to monitor the effectiveness of their treatments.
Children and cholesterol testing
For most children, the National Heart, Lung, and Blood Institute recommends one cholesterol screening test between the ages of 9 and 11, and another cholesterol screening test between the ages of 17 and 21.
If your child has a family history of early-onset coronary artery disease or a personal history of obesity or diabetes, your doctor might recommend earlier or more-frequent cholesterol testing.
There's little risk in getting a cholesterol test. You might have soreness or tenderness around the site where your blood is drawn. Rarely, the site can become infected.
How you prepare
Generally you're required to fast, consuming no food or liquids other than water, for nine to 12 hours before the test. Some cholesterol tests don't require fasting, so follow your doctor's instructions.
What you can expect
During the procedure
A cholesterol test is a blood test, usually done in the morning since you'll need to fast for the most accurate results. Blood is drawn from a vein, usually from your arm.
Before the needle is inserted, the puncture site is cleaned with antiseptic and an elastic band is wrapped around your upper arm. This causes the veins in your arm to fill with blood.
After the needle is inserted, a small amount of blood is collected into a vial or syringe. The band is then removed to restore circulation, and blood continues to flow into the vial. Once enough blood is collected, the needle is removed and the puncture site is covered with a bandage.
The procedure will likely take a couple of minutes. It's relatively painless.
After the procedure
There are no precautions you need to take after your cholesterol test. You should be able to drive yourself home and do all your normal activities. You might want to bring a snack to eat after your cholesterol test is done, if you've been fasting.
Cholesterol and triglyceride tests are blood tests that measure the total amount of fatty substances ( cholesterol and triglycerides ) in the blood.
Cholesterol travels through the blood attached to a protein. This cholesterol-protein package is called a lipoprotein. Lipoprotein analysis (lipoprotein profile or lipid profile) measures blood levels of total cholesterol , LDL cholesterol , HDL cholesterol , and triglycerides.
Cholesterol. The body uses cholesterol to help build cells and produce hormones . Too much cholesterol in the blood can build up inside arteries, forming what is known as plaque . Large amounts of plaque increase your chances of having a heart attack or stroke.
HDL (high-density lipoprotein) helps move cholesterol out of the body. HDL does this by binding with cholesterol in the bloodstream and carrying it back to the liver for disposal. HDL may also reduce inflammation. A high HDL level is linked with a lower risk of heart disease.
LDL (low-density lipoprotein) carries mostly fat and only a small amount of protein from the liver to other parts of the body. A certain level of LDL in your blood is normal and healthy because LDL moves cholesterol to the parts of your body that need it. But it is sometimes called "bad cholesterol" because a high level may increase your chances of developing heart disease.
VLDL: (very low-density lipoprotein) contains very little protein. The main purpose of VLDL is to distribute the triglyceride produced by your liver. A high VLDL cholesterol level can cause the buildup of cholesterol in your arteries and increases your risk of heart disease and stroke.
Triglycerides are a type of fat the body uses to store energy and give energy to muscles. Only small amounts are found in the blood. Having a high triglyceride level along with a high LDL cholesterol may increase your chances of having heart disease more than having only a high LDL cholesterol level.
Cholesterol screening is often available in supermarkets, pharmacies, shopping malls, and other public places. Home cholesterol testing kits also are available. The results of tests done outside a doctor's office or lab may not be accurate. If you have cholesterol screening done outside your doctor's office, talk with your doctor about the accuracy of the results.
Why It Is Done
Cholesterol and triglyceride testing is done:
As part of a routine physical exam to screen for a lipid disorder .
To check your response to medicines used to treat lipid disorders.
To help find your risk of having heart and blood flow problems, including heart attack and stroke.
If you have unusual symptoms, such as yellow fatty deposits in the skin (xanthomas), which may be caused by a rare genetic disease that causes very high cholesterol levels.
Cholesterol and triglyceride screening
Talk to your doctor about when you should get a cholesterol test.
What is Cholesterol Test?
A complete cholesterol test is also called a lipid panel or lipid profile.Your doctor can use it to measure the amount of “good” and “bad” cholesterol and triglyceride, a type of fat, in your blood. Cholesterol is a soft, waxy fat that your body needs to function properly. However, too much cholesterol can lead to heart disease, stroke, atherosclerosis, a clogging or hardening of your arteries.
Who Is at Risk of High Cholesterol?
Cholesterol testing is very important if you:
1) Have a family history of high cholesterol or heart disease
2) Are overweight or obese
3) Drink alcohol frequently
4) Smoke cigarettes
5) Lead an inactive lifestyle
6) Have diabetes, kidney disease, poly cystic ovary syndrome, or an under active thyroid gland
All of above things can increase your risk of developing high cholesterol.
What Does a Cholesterol Test Measure?
A complete cholesterol test measures four types of lipids, or fats, in your blood:
Total cholesterol: This is the total amount of cholesterol in your blood.
Low-density lipoprotein (LDL) cholesterol: This is referred to as “bad” cholesterol. Too much of it raises your risk of heart attack, stroke, and atherosclerosis.
High-density lipoprotein (HDL) cholesterol: This is referred to as “good” cholesterol because it helps remove LDL cholesterol from your blood.
Triglyceride: When you eat, your body converts the calories it doesn’t need into triglyceride, which are stored in your fat cells. People who are overweight, diabetic, eat too many sweets, or drink too much alcohol can have high triglyceride levels.
Preparation for a Cholesterol Test
In some cases, your doctor may ask you to fast before having your cholesterol levels tested. If you’re only getting your HDL and total cholesterol levels checked, you may be able to eat beforehand. However, if you’re having a complete lipid profile done, you should avoid eating or drinking anything other than water for nine to 12 hours before your test.
Before your test, you should also tell your doctor about:
Any symptoms or health problems you’re experiencing
Your family history of heart health
All medications and supplements that you’re currently taking
If you’re taking medications that could increase your cholesterol levels, such as birth control pills, your doctor may ask you to stop taking them a few days before your test.
How Is a Cholesterol Test Performed?
To check your cholesterol levels, your doctor will need to get a sample of your blood.You will probably have your blood drawn in the morning, sometimes after fasting since the night before.
A blood test is an outpatient procedure. It takes only a few minutes and is relatively painless. It’s usually performed at a diagnostic lab. In some cases, it can also be performed during a regular doctor visit, at a local pharmacy, or even at home. Walk-in clinic rates can cost anywhere from INR 300 to INR 1000.Cholesterol testing at a local pharmacy can cost around INR 350. An at-home test can cost less. While tests that need to be shipped to a lab can cost more.
There are very few risks associated with having your blood drawn for a cholesterol test. You may feel slightly faint or have some soreness or pain at the site where your blood was drawn. There’s also a very slight risk of infection at the puncture site.
What Do the Test Results Mean?
Cholesterol levels are measured in milligrams (mg) of cholesterol per decilitre (dL) of blood. Ideal results for most adults are:
LDL: 70 to 130 mg/dL (the lower the number, the better)
HDL: more than 40 to 60 mg/dL (the higher the number, the better)
Total cholesterol: less than 200 mg/dL (the lower the number, the better)
Triglyceride: 10 to 150 mg/dL (the lower the number, the better)
If your cholesterol numbers are outside of the normal range, you may be at a higher risk of heart disease, stroke, and atherosclerosis. If your test results are abnormal, your doctor may order a blood glucose test to check for diabetes. Your doctor might also order a thyroid function test to determine if your thyroid is under active.
Can Test Results Be Wrong?
In some cases, cholesterol test results can be wrong. For example, a study published in the Journal of the American College of Cardiology found that one common method for calculating LDL cholesterol levels often produces inaccurate results.
Improper fasting, medications, human error, and a variety of other factors can cause your test to produce false-negative or false-positive results. Testing both your HDL and LDL levels typically produces more accurate results than checking your LDL alone.
Next Steps and Treatment
High cholesterol can be treated with lifestyle changes and medication. Lowering high levels of LDL in your blood can help you avoid problems with your heart and blood vessels.
To help lower your cholesterol levels:
Quit smoking tobacco and limit your alcohol consumption. Avoid high-fat and high-sodium foods, while maintaining a well-balanced diet. Eat a wide variety of vegetables, fruits, whole-grain products, low-fat dairy products, and lean sources of protein. Exercise regularly. Try to do 150 minutes of moderate intensity aerobic activity per week, as well as two sessions of muscle strengthening activities. Your doctor may put you on a “therapeutic lifestyle changes” or TLC diet. Under this meal plan, only 7 percent of your daily calories should come from saturated fat. It also requires you to get less than 200 mg of cholesterol from your food each day.
Some foods help your digestive tract absorb less cholesterol. For example, your doctor may encourage you to eat more.
Oats, barley, and other whole grains
Fruits such as apples, pears, bananas, and oranges
Vegetables such as eggplant and okra
Beans and legumes, such as kidney beans, chickpeas, and lentils
Obesity is also a common risk factor for high cholesterol and heart disease. Your doctor may encourage you to lose weight by cutting calories from your diet and exercising more.
Taking medications such as statins can also help keep your cholesterol in check. These medications help lower your LDL levels.
Older women, over 75, taking statins, which are cholesterol-lowering drugs, may be at 33 per cent increased risk of developing diabetes, according to a new study. The risk increased to over 50 per cent for women taking higher doses of statins, said researchers of the University of Queensland in Australia. Statins are prescribed to reduce the incidence of cardiovascular events such as heart attacks and strokes as well as reduce mortality. This study links its usage to the risk of diabetes, one of the most dangerous kinds of lifestyle diseases affecting millions across the globe.
"The study showed that almost 50 per cent of women in their late seventies and eighties took statins, and five per cent were diagnosed with new-onset diabetes," said Mark Jones from the University of Queensland.
"What's most concerning was that we found a 'dose effect' where the risk of diabetes increased as the dosage of statins increased," Jones added.
For the study, published in the journal Drugs and Ageing, the team included 8,372 Australian women born between 1921 and 1926. The results showed that elderly women should not be exposed to higher doses of statins. Elderly women currently taking statins should be carefully and regularly monitored for increased blood glucose to ensure early detection and appropriate management of this potential adverse effect, including consideration of de-prescribing, the researchers suggested.
"Those elderly women taking statins should be carefully and regularly monitored for increased blood glucose to ensure early detection and management of diabetes," added Jones.
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