Exams and Tests
You will need a blood test to check
whether you have
high cholesterol.
- A total cholesterol test measures whether your
cholesterol is high or low. You can have this test done at any time, even if
you recently had a meal or snack.
- A
lipoprotein analysis is a more thorough test. It
measures your total cholesterol as well as your
LDL,
HDL, and
triglyceride levels. It is called a fasting test
because you are not supposed to eat for 9 to 12 hours before having your blood
drawn.
- A direct LDL test measures your LDL level only. You can
have this test done at any time, even if you recently had a meal or
snack.
Although knowing your total cholesterol level is important,
a lipoprotein test will help your doctor make certain decisions about your
treatment. Knowing the levels of your good cholesterol (HDL), bad cholesterol
(LDL), and triglycerides will help your doctor decide whether to prescribe
medicine right away or whether you first can try making changes in your diet
and lifestyle to lower your cholesterol.
The following will help
you understand the results of your test:
Total cholesterol| Best | Less than 200 milligrams per deciliter (mg/dL) |
|---|
| Borderline high | 200 to 239 |
|---|
| High | 240 or above |
|---|
LDL (bad) cholesterol| Best | Below 100 mg/dL |
|---|
| Near best | 100 to 129 |
|---|
| Borderline high | 130 to 159 |
|---|
| High | 160 to 189 |
|---|
| Very high | 190 and above |
|---|
HDL (good) cholesterol | Best | 60 mg/dL or higher protects against heart disease |
|---|
| Good | 40 and above |
|---|
| Bad | Below 40 |
|---|
Triglycerides| Borderline high | 150 to 199 mg/dL |
|---|
| High | 200 or more |
|---|
During your doctor visit, it will be important
to discuss other things that increase your risk for heart problems, such as
smoking,
diabetes,
high blood pressure, and a family history of high
cholesterol and heart attack.
You may need other tests to
determine whether another health problem, such as
low thyroid, is causing your high cholesterol. Some
medicines may also cause high cholesterol, so it is important to tell your
doctor about everything you take.
Along with your cholesterol
levels, your doctor will use this information to determine your risk for
coronary artery disease (CAD) and
heart attack. If you have a high risk of heart
disease, or if you already have heart problems, your doctor will be more likely
to prescribe medicine. For more information, see the topic
Coronary Artery Disease.
If you have high
cholesterol or high blood pressure, you should get tested regularly for
diabetes. Studies show that finding and treating diabetes early can lower the
risk of heart attack.2
The American Heart
Association (AHA) and the U.S. Centers for Disease Control and Prevention (CDC)
recommend
C-reactive protein (CRP) testing for some people who
are at risk for getting coronary artery disease. There are two types of CRP
tests: the older CRP measurement and a newer, high-sensitivity CRP, often
called cardiac CRP. The high-sensitivity test helps find out the chances of a
having a sudden heart problem, such as a
heart attack.
Two studies on CRP levels
and statin treatment show that testing CRP levels may help predict heart attack
risk even when a person has a normal or low level of LDL cholesterol.3, 4 Another study found higher CRP
levels in people who have health problems related to
metabolic syndrome. 5 These
problems include too much fat around the waist, elevated blood pressure,
high triglycerides, elevated blood sugar, and low HDL
cholesterol.
Ask your doctor if CRP testing would be helpful in
guiding your treatment.6
Early Detection
Some doctors and health
organizations recommend that everyone older than 20 be checked for high
cholesterol. How often you should be checked depends on whether you have other
health problems and your overall chance of heart disease.