From the Guidelines
Diagnosing elevated cholesterol requires a blood test called a lipid panel, which measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides, with LDL-Cholesterol (LDL-C) being the primary lipid analysis for screening, risk estimation, diagnosis, and management 1.
Key Considerations
- The lipid panel test typically requires fasting for 9-12 hours before the test for the most accurate results.
- Generally, total cholesterol above 200 mg/dL, LDL above 100 mg/dL, HDL below 40 mg/dL for men or below 50 mg/dL for women, or triglycerides above 150 mg/dL may indicate high cholesterol.
- Your healthcare provider will interpret these results considering your overall health and risk factors, and may recommend repeat testing to confirm the diagnosis, as cholesterol levels can fluctuate.
Additional Tests and Considerations
- Additional tests might include measuring apolipoprotein B or performing advanced lipid testing in certain cases, such as familial hypercholesterolemia, which should be suspected in patients with severely elevated LDL-C (in adults >5 mmol/L [190 mg/dL], in children > 4 mmol/L [150 mg/dL]) 1.
- Lipoprotein(a) [Lp(a)] levels should also be measured in patients at high risk of cardiovascular disease (CVD), with a target level below 50 mg/dL 1.
Screening Recommendations
- Regular screening is recommended every 4-6 years for adults with normal risk, starting at age 20, and more frequently for those with risk factors like family history, obesity, diabetes, or existing heart disease.
- Lipid testing should be performed when initial glycemic control has been achieved and annually thereafter in patients with diabetes, with optimal goals being LDL cholesterol < 100 mg/dL (2.6 mmol/L), HDL cholesterol > 35 mg/dL (0.91 mmol/L), and triglycerides < 150 mg/dL (1.7 mmol/L) 1.