Tessa Quinn
High cholesterol usually has no symptoms, and the only way to know if you have it is to get a cholesterol test. This is usually done through a simple blood test, often referred to as a lipid profile or lipoprotein profile, which can be performed at a hospital or clinic. The test measures levels of low-density lipoprotein (LDL) or bad cholesterol, high-density lipoprotein (HDL) or good cholesterol, triglycerides, and total cholesterol. These numbers help healthcare professionals assess a patient's cardiovascular risk and determine the best course of treatment, which may include lifestyle changes or cholesterol-lowering medication. While home cholesterol test kits are available, in-person cholesterol tests performed by healthcare providers are considered more reliable.
| Characteristics | Values |
|---|---|
| Test Type | Blood test, also known as a "lipid profile" or "lipoprotein profile" |
| Test Procedure | A health care professional takes a blood sample for analysis in a laboratory |
| Fasting | May be required 9-12 hours before the test |
| Test Results | Cholesterol level in milligrams per deciliter of blood (mg/dL) |
| Test Frequency | Every four to six years for adults with low risk; more often for those with cardiovascular disease or elevated risk |
| Age Considerations | Children and adolescents should have their cholesterol checked between ages 9 and 11, and again between 17 and 21 |
| Risk Factors | Family history, age, sex, smoking status, blood pressure, weight, physical exam results, medical history, and comorbidities |
| Home Testing | Home test kits are available but may have variable reliability; results should be discussed with a healthcare provider |
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What You'll Learn
Fasting before a cholesterol test
Traditionally, patients have been instructed to fast before undergoing a cholesterol test, which typically involves refraining from eating, drinking certain beverages, and taking medications for 9 to 12 hours prior to the test. This is done to ensure accurate measurement of lipid levels, particularly low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides.
However, recent studies have challenged the necessity of fasting for routine cholesterol screening. Research has shown that eating before a cholesterol test has a minimal impact on HDL-C and total cholesterol levels, with variations of around 2% between fasting and non-fasting patients. Additionally, skipping the fasting requirement improves patient compliance, safety, and efficient use of healthcare resources.
Based on this emerging evidence, non-fasting lipid profiles are now considered a reasonable alternative for risk assessment, treatment decisions, and monitoring treatment effects. Fasting becomes more crucial for patients with very high triglyceride levels or those taking lipid-lowering medications to monitor low-density lipoprotein cholesterol levels accurately.
While the requirement for fasting before a cholesterol test is evolving, it is important to follow the instructions provided by your healthcare professional. They will advise you on whether fasting is necessary for your specific circumstances and, if so, provide guidance on the duration and any other relevant preparations to ensure accurate test results.
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Blood sample analysis
To monitor cholesterol levels, a simple blood test, also known as a "lipid profile", is carried out. This test requires a blood draw, which is typically performed by a healthcare professional. The blood sample is then analysed in a laboratory to measure the levels of various cholesterol components and assess an individual's cardiovascular risk.
The blood sample analysis involves measuring specific cholesterol components, including:
- High-Density Lipoprotein (HDL): HDL cholesterol is often referred to as "good" cholesterol. Higher levels of HDL can lower the risk of heart disease and stroke.
- Low-Density Lipoprotein (LDL): LDL cholesterol is known as "bad" cholesterol. High levels of LDL can lead to plaque buildup in the arteries, increasing the risk of heart disease and stroke.
- Triglycerides: Triglycerides are a type of fat found in the blood that the body uses for energy. High triglyceride levels, combined with low HDL or high LDL levels, can increase the risk of heart attack and stroke.
- Total Cholesterol: This refers to the overall amount of cholesterol in the blood, calculated based on the levels of HDL, LDL, and triglycerides.
During the blood sample analysis, these components are measured and evaluated to determine an individual's cholesterol levels. The results are typically reported in milligrams per deciliter of blood (mg/dL).
It is important to note that cholesterol levels are just one aspect of overall health. Healthcare professionals will consider these results alongside other factors, such as age, sex, family history, lifestyle choices (such as smoking), and other health conditions, to assess an individual's comprehensive cardiovascular risk. This holistic approach helps determine the necessary steps, such as lifestyle changes or cholesterol-lowering medications, to mitigate the risk of heart disease and stroke.
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Recommended testing frequency
The recommended frequency of cholesterol testing varies depending on age, health conditions, and risk factors. The American Heart Association recommends that all adults aged 20 and older with low risk get their cholesterol checked every four to six years. This can be done through a simple blood test or lipid profile, which measures HDL ("good") cholesterol, LDL ("bad") cholesterol, and triglyceride levels.
For individuals with certain health conditions or risk factors, more frequent testing may be advised. People with cardiovascular disease or an elevated risk, such as those with diabetes, obesity, inflammatory conditions, or a family history of heart disease, may need their cholesterol monitored more often. In these cases, a healthcare professional may recommend cholesterol testing every one to two years or even more frequently, depending on the individual's overall health and risk assessment.
Children and adolescents should also have their cholesterol checked at specific age intervals. It is recommended that children have their cholesterol checked at least once between the ages of 9 and 11, while adolescents should be screened between the ages of 17 and 21. Children with obesity or diabetes may require more frequent cholesterol screenings.
After the age of 40, healthcare professionals often calculate a 10-year risk of having a heart attack or stroke. This calculation takes into account cholesterol levels, age, sex, family history, and other lifestyle factors such as smoking. Based on this assessment, healthcare providers can determine if more frequent cholesterol testing is necessary and discuss treatment options if cholesterol levels are not optimal.
It is important to note that cholesterol testing is just one aspect of overall health management. Regular monitoring of blood pressure, body mass index, and fasting blood sugar, in addition to cholesterol levels, is crucial for maintaining cardiovascular health. Additionally, cholesterol home test kits are available for individuals who want to monitor their cholesterol levels more frequently or between healthcare appointments. However, these results should be considered approximations, and consulting with a healthcare provider for a comprehensive risk assessment is essential.
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Home testing kits
Home cholesterol testing kits are a convenient way to monitor your cholesterol levels. These kits provide instant results and can be easily used at home. They typically come with a meter, lancets, test strips, and other testing supplies. To use the kit, you simply prick your finger with the lancet to draw blood, and then apply the blood to the test strip. The test strip will change colour, which you can then match to a guide to determine your cholesterol level.
It is important to note that home cholesterol tests may not provide a complete lipid profile. While they can give you an indication of your total cholesterol level, they may not measure LDL, HDL, and triglyceride levels. For a more comprehensive understanding of your cholesterol levels, it is recommended to use a kit that tests for all these components, such as CardioChek, Curo L5, or PT Program, which are FDA-approved.
When choosing a home testing kit, it is essential to select one that is accurate and reliable. According to FDA testing standards, approved at-home cholesterol tests must be as accurate as traditional lab tests when used correctly. Accuracy depends on proper use, so it is crucial to follow the instructions carefully. Factors such as improper filling of the test strip, expired test materials, or not fasting beforehand can impact the accuracy of the results.
Home cholesterol test kits are particularly useful for individuals who have already been diagnosed with high cholesterol. By using these kits periodically, individuals can monitor their cholesterol levels over time and assess the effectiveness of their management plan. It is recommended to discuss the use of home test kits with your physician to determine the appropriate frequency of testing and interpret the results in the context of your overall health.
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Assessing cardiovascular risk
To determine cardiovascular risk, healthcare professionals will consider these cholesterol test results alongside other factors such as age, sex, and family history. Additionally, blood pressure, body mass index (BMI), and fasting blood sugar measurements are important data points for establishing cardiovascular risk.
For individuals with specific risk factors, such as smoking, diabetes, or a family history of heart disease, more frequent cholesterol assessments may be recommended. The calculation of the 10-year risk of having a heart attack or stroke is also considered for patients over 40.
There are also specific guidelines for certain populations, such as First Nations people, where additional risk factors are considered, including severe mental illness and family history of coronary heart disease or stroke in younger relatives. Furthermore, healthcare professionals can utilise tools like the ESC CVD Risk Calculation App, which provides guidance on appropriate calculators for different patient populations and offers up to 10-year or lifelong risk assessments.
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Frequently asked questions
The American Heart Association recommends that all adults aged 20 and older get their cholesterol and other traditional risk factors checked every four to six years as long as their risk remains low. People with cardiovascular disease or elevated risk factors may need to get their cholesterol checked more frequently.
A cholesterol test, or screening, requires a simple blood draw. The test checks your levels of low-density lipoprotein (LDL) or "bad" cholesterol, high-density lipoprotein (HDL) or "good" cholesterol, triglycerides, and total cholesterol.
You will be told if you should fast before your test. Fasting usually means not eating, drinking certain beverages, and taking medications 9 to 12 hours before the cholesterol test.
Your test report will show your cholesterol level in milligrams per deciliter of blood (mg/dL). Your healthcare professional will consider your cholesterol test results in the context of your age, sex, family history, and other relevant factors to determine your cardiovascular risk and discuss treatment options if necessary.
