A scary cholesterol test foreshadowed Mark Miller's two heart attacks. He has since lost weight and is now on cholesterol-lowering medication.
(MARK MILLER)
The American Heart Association recommends that all adults 20 and older have a cholesterol test every five years. Men 45 and older, women 50 and older, and people with risk factors for heart disease, including high cholesterol, should be tested more often, perhaps every one or two years. Your doctor will suggest the best schedule for you.
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Your blood contains at least three different types of cholesterol that can shape your risk for heart trouble. "No one looks at total cholesterol anymore; we look at good and bad," says Leslie Cho, MD, the director of preventive cardiology and rehabilitation at the Cleveland Clinic. "The level we get concerned about depends on the patient's other risk factors." Other risk factors for heart disease include high blood pressure, smoking, diabetes, being overweight, and depression.
Bad cholesterol, or low-density lipoprotein (LDL) cholesterol, is what doctors usually worry about most. It can clog the arteries and set the stage for a heart attack. Even if you don't have any other risk factors for heart disease, an LDL level above 160 mg/dL could mean trouble. If you can't bring it down through diet and exercise, your doctor may put you on a cholesterol-lowering drug, such as a statin. If you're at a high risk for heart disease, you should do whatever it takes to bring your LDL below 100 mg/dL.
After Miller's heart attacks, his doctor put him on a restricted diet and an exercise program. Though it didn't prevent Miller from eventually needing heart surgery, he did lose 165 pounds and was able to get back to coaching seven days after his surgery.
"Now I run three to four miles daily and walk 10,000 steps," says Miller. "I feel better today at age 62 than I ever did at 32." He also takes cholesterol-lowering medications.
The following information from our A-Z Health Library explains what doctors look for when they test your cholesterol.
- HDL (high-density lipoprotein) cholesterol helps remove fat from the body by binding with it in the bloodstream and carrying it back to the liver for disposal. It is sometimes called "good" cholesterol. A high level of HDL cholesterol may lower your chances of developing heart disease or stroke.
- LDL (low-density lipoprotein) cholesterol carries mostly fat and only a small amount of protein from the liver to other parts of the body. It is sometimes called "bad cholesterol." A high LDL cholesterol level may increase your chances of developing heart disease.
- VLDL: (very low-density lipoprotein) cholesterol 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. 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.
Last Updated: September 13, 2007 
