High Cholesterol

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.

Your total cholesterol level is important but the levels of your lipoproteins, including LDL, HDL, and triglycerides, help your doctor make decisions about whether you need treatment for high cholesterol. Your doctor will also take into account your overall health and your risk of heart attack.

The following tables will help you understand the results of your cholesterol tests. All numbers are milligrams per deciliter (mg/dL), but most people just say the numbers.

Total cholesterol

Your total cholesterol level shows if your cholesterol is high or low. If you have high cholesterol, your doctor will want to know your LDL and HDL levels before deciding whether you need treatment and what sort of treatment you need.

LDL cholesterol

You want your LDL level to be low. But how low your LDL should be depends on your risk of heart attack. This table shows the LDL levels for someone with an average risk of heart attack. Your own LDL goal may change, based on your risk of heart attack. This risk is based on your age and on whether you smoke, have high blood pressure, have a low HDL level, have diabetes, or have a family history of early heart disease.

Your doctor will help decide what your LDL goal is and if you need any treatment to lower your LDL. The higher your risk of heart attack, the lower your LDL goal.

HDL cholesterol

You want your HDL level high. HDL (good) cholesterol goals are different for men and women. But for everyone, the higher your HDL, the better. HDL over 60 helps protect against a heart attack. HDL below 40 increases your risk of heart problems. A high HDL number can help offset a high LDL number.

Triglycerides

You want your triglyceride level to be low.

When you visit your doctor to talk about your cholesterol test, you will talk about 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. Your doctor will use all of this information, along with your cholesterol numbers, to decide whether you need treatment and what type of treatment you need.

Your doctor will help you figure out your risk of heart attack or stroke. But you can check your own risk for a heart attack by using the Interactive Tool: Are You at Risk for a Heart Attack?

If you have a high risk of a heart attack, or if you already have heart problems, your doctor will be more likely to prescribe medicine along with lifestyle changes. For more information about heart disease, see the topic Coronary Artery Disease.

You may need other tests to determine whether another health problem, such as hypothyroidism, is causing your high cholesterol. Some medicines may also cause high cholesterol, so it is important to tell your doctor about everything you take.

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

A C-reactive protein (CRP) test may be done for some people who are at risk for getting coronary artery disease. A special type of CRP test, the high-sensitivity CRP test (hs-CRP), can help find out your chance of having a sudden heart problem, such as a heart attack. This test may be done even if you have a normal or low level of LDL cholesterol.

Early Detection

Some doctors and health organizations recommend that everyone older than 20 be checked for high cholesterol. How often you need to be checked depends on whether you have other health problems and your overall chance of heart disease.

• When to have cholesterol testing
• Cholesterol testing for children and teens
• What you should know about public cholesterol tests