Cholesterol testing and results
Cholesterol is a soft, wax-like substance found in all parts of the body. Your body needs a little bit of cholesterol to work properly. But too much cholesterol can clog your arteries and lead to heart disease.
Cholesterol blood tests are done to help you and your health care provider better understand your risk for heart disease, stroke, and other problems caused by narrowed or blocked arteries.
The ideal values for all cholesterol results depend on whether you have heart disease, diabetes, or other risk factors. Your provider can tell you what your goal should be.
Cholesterol test results; LDL test results; VLDL test results; HDL test results; Coronary risk profile results; Hyperlipidemia-results; Lipid disorder test results; Heart disease - cholesterol results
Some cholesterol is considered good and some is considered bad. Different blood tests can be done to measure each type of cholesterol.
Your provider may order only a total cholesterol level as the first test. It measures all types of cholesterol in your blood.
You may also have a lipid (or coronary risk) profile, which includes:
- Total cholesterol
- Low density lipoprotein (LDL cholesterol)
- High density lipoprotein (HDL cholesterol)
- Triglycerides (another type of fat in your blood)
- Very low density lipoprotein (VLDL cholesterol)
Lipoproteins are made of fat and protein. They carry cholesterol, triglycerides, and other fats, called lipids, in the blood to various parts of the body.
Video: Cholesterol and triglyceride test
When Should You Be Tested?
Everyone should have their first screening test by age 35 for men, and age 45 for women. Some guidelines recommend starting at age 20.
You should have a cholesterol test done at an earlier age if you have:
- Heart disease
- High blood pressure
- A strong family history of heart disease
Follow-up testing should be done:
- Every 5 years if your results were normal.
- More often for people with diabetes, high blood pressure, heart disease, stroke, or blood flow problems to the legs or feet.
- Every year or so if you are taking medicines to control high cholesterol.
A total cholesterol of 180 to 200 mg/dL (10 to 11.1 mmol/l) or less is considered best.
You may not need more cholesterol tests if your cholesterol is in this normal range.
LDL (Bad) Cholesterol
LDL cholesterol is sometimes called "bad" cholesterol. LDL can clog your arteries.
You want your LDL to be low. Too much LDL is linked to heart disease and stroke.
Your LDL is most often considered to be too high if it is 190 mg/dL or higher.
Levels between 70 and 189 mg/dL (3.9 and 10.5 mmol/l) are most often considered too high if:
- You have diabetes and are between ages 40 and 75
- You have diabetes and a high risk of heart disease
- You have a medium or high risk of heart disease
- You have heart disease, history of a stroke, or poor circulation to your legs
Health care providers have traditionally set a target level for your LDL cholesterol if you are being treated with medicines to lower your cholesterol.
- Some newer guidelines now suggest that providers no longer need to target a specific number for your LDL cholesterol. Higher strength medicines are used for the highest risk patients.
- However, some guidelines still recommend using specific targets.
HDL (Good) Cholesterol
You want your HDL cholesterol to be high. Studies of both men and women have shown that the higher your HDL, the lower your risk of coronary artery disease. This is why HDL is sometimes referred to as "good" cholesterol.
HDL cholesterol levels greater than 40 to 60 mg/dL (2.2 to 3.3 mmol/l) are desired.
VLDL (Bad) Cholesterol
VLDL contains the highest amount of triglycerides. VLDL is considered a type of bad cholesterol, because it helps cholesterol build up on the walls of arteries.
Normal VLDL levels are from 2 to 30 mg/dL (0.1 to 1.7 mmol/l).
Sometimes, your cholesterol levels may be low enough that your provider will not ask you to change your diet or take any medicines.
Video: Understanding cholesterol results
Arnett DK, Blumenthal RS, Albert MA, Buroker AB, et al. 2019 ACC/AHA Guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019 Sep 10;74(10):1376-1414. PMID: 30894319 pubmed.ncbi.nlm.nih.gov/30894319/.
American Diabetes Association. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2021. Diabetes Care. 44(Suppl 1):S125-S150. PMID: 33298421 pubmed.ncbi.nlm.nih.gov/33298421/.
Fox CS, Golden SH, Anderson C, et al. Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Circulation. 2015;132(8):691-718. PMID: 26246173 www.ncbi.nlm.nih.gov/pubmed/26246173.
Gennest J, Libby P. Lipoprotein disorders and cardiovascular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 48.
Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;73(24):e285-e350.2018. PMID: 30423393 www.ncbi.nlm.nih.gov/pubmed/30423393.
Rohatgi A. Lipid measurement. In: de Lemos JA, Omland T, eds. Chronic Coronary Artery Disease: A Companion to Braunwald's Heart Disease. Philadelphia, PA: Elsevier; 2018:chap 8.