Blood Cholesterol Diagnosis
Your healthcare provider will diagnose you with high blood cholesterol based on your medical and family history, a physical exam, and a blood test of your cholesterol levels.
Medical history and physical exam
Your healthcare provider will ask about your eating habits, physical activity, family history, medicines you are taking, and other risk factors for heart or blood vessel diseases.
During your physical exam, your provider will check for signs of very high blood cholesterol, such as , or signs of other health conditions that can cause high blood cholesterol.
Screening for high cholesterol
Your healthcare provider may order a blood test called a panel to screen for unhealthy cholesterol levels.
Your healthcare provider may ask you to fast for 8 to 12 hours before a lipoprotein panel.
Lipoprotein (lipid) panel
A lipoprotein panel, also called a lipid panel or lipid profile, measures the levels of LDL and HDL cholesterol and triglycerides in your blood. Cholesterol and triglyceride levels that are higher than normal may be signs of higher risk of coronary heart disease.
A lipoprotein panel gives the following types of information:
- Total cholesterol
- LDL (“bad”) cholesterol, which is the main source of cholesterol buildup and blockages in the arteries
- HDL (“good”) cholesterol, which helps decrease cholesterol blockages in the arteries
- Triglycerides, which are another type of fat in your blood
Your lipoprotein panel may also provide other potentially useful numbers, such as your non-HDL cholesterol (total cholesterol minus HDL cholesterol) and remnant LDL (total cholesterol minus LDL and HDL cholesterol).
The goal for a healthy lipid profile is to have non-HDL levels below 130 milligrams (mg) per deciliter (dL) with an HDL of at least 40 mg/dL for men and 50 mg/dL for women. Check with your provider on the lipid levels that are best for you.
| Blood lipids | Measurement: Plasma total and HDL cholesterol with calculation of non-HDL cholesterol Example tools for measurement: Fasting or nonfasting blood sample | Metric: Non-HDL cholesterol (mg/dL) If drug-treated level, subtract 20 points | Metric: Non-HDL cholesterol (mg/DL), starting no later than age 9-11 y and earlier per clinical discretion If drug-treated level, subtract 20 points |
For healthy persons, how often you get a lipid panel done depends on your age, risk factors, and family history of high blood cholesterol or cardiovascular diseases, such as atherosclerosis, heart attack, or stroke.
Here is a general guide:
- Ages 19 or younger: Screening begins at ages 9 to 11 and should be repeated every 5 years. Screening may be performed as early as age 2 if there is a family history of high blood cholesterol, heart attack, or stroke.
- Ages 20 to 65: Younger adults should be screened every 5 years. Men ages 45 to 65 and women ages 55 to 65 should be screened every 1 to 2 years.
- Older than 65: Older adults should be screened every year.
Lipoprotein-a
A lipoprotein-a, or Lp(a), test is not usually part of a routine lipid panel. High levels of Lp(a) may mean you are at higher risk of heart or blood vessel diseases, even if your other cholesterol levels are healthy. The genes you inherit from your parents determine how much Lp(a) you have. Your Lp(a) level is unlikely to change much from childhood to old age.
Your healthcare provider may order an Lp(a) test if you have a family history of stroke, early heart disease, such as a heart attack, or do not know your family medical history. If you have a high Lp(a) level, your provider may prescribe , a medicine to help lower your heart disease risk, even if your other cholesterol levels are in the healthy range.
Find out what your cholesterol numbers mean and use a tool to estimate the risk of having a heart attack.