From the Guidelines
To conduct a cholesterol test, a fasting lipid profile should be performed, which consists of a total cholesterol, high-density lipoprotein (HDL) cholesterol, and triglyceride measurement, with low-density lipoprotein (LDL) cholesterol calculated by the Friedewald equation in patients with triglycerides <300 mg/dL, as recommended by the American College of Cardiology Foundation/American Heart Association task force on performance measures 1.
Procedure for Conducting a Cholesterol Test
The procedure involves:
- Fasting for 9-12 hours before the test, during which only water is permitted
- A healthcare professional drawing a small blood sample, typically from a vein in your arm, using a needle and collection tube
- The blood sample is then sent to a laboratory for analysis, which measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides
- Results are usually available within a few days
Important Considerations
- For accurate results, avoid alcohol for 24 hours before the test and inform your doctor about any medications you're taking, as some can affect cholesterol levels
- Some newer tests don't require fasting, but your healthcare provider will specify if this applies to your situation
- Regular cholesterol testing is important because high cholesterol typically has no symptoms but significantly increases the risk of heart disease and stroke by contributing to plaque buildup in arteries
Guidelines for Cholesterol Testing
- The American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation recommend obtaining fasting measures of total cholesterol, HDL, LDL, and triglycerides, and assessing current treatment and compliance 1
- The American College of Cardiology Foundation/American Heart Association task force on performance measures recommends performing a fasting lipid profile in patients with at least one risk factor for coronary heart disease, with a denominator of all patients 18 years of age and over at the start of the measurement period with at least one risk factor for CHD and at least two visits during the measurement period 1
From the Research
Cholesterol Test Procedure
To conduct a cholesterol test, the following steps can be taken:
- The test can be performed using a fingerstick cholesterol measurement, as seen in the study 2
- Total serum cholesterol (TC) and high density lipoprotein-cholesterol (HDL-C) are recommended as initial screening tests for dyslipidemia in the general population 3
- The test can be done on a single sample at 5-year intervals beginning at age 20, as recommended by the National Cholesterol Education Program (NCEP) 3
- For adults with elevated cholesterol levels, a lipoprotein analysis consisting of a 12-hour fasting TC, HDL-C, triglyceride, and estimated low density lipoprotein-cholesterol (LDL-C) is recommended 3
Types of Cholesterol Tests
Different types of cholesterol tests are available, including:
- Quantitative meters, such as the Roche Accutrend Plus, which has been shown to have excellent diagnostic and analytic performance 4
- Semi-quantitative strip tests, such as the Veroval and Mylan MyTest, which have been shown to have poor accuracy and diagnostic performance 4
- Laboratory-based tests, which can provide a more comprehensive lipid profile, including TC, HDL-C, triglycerides, and LDL-C 3
Preparation and Follow-up
To prepare for a cholesterol test:
- Fasting for 12 hours may be required for certain types of tests, such as lipoprotein analysis 3
- Follow-up tests may be necessary to confirm the results and monitor changes in cholesterol levels over time 2, 3
- Patients with elevated cholesterol levels should be instructed to follow up with their primary care physicians and make lifestyle changes, such as diet and exercise, to manage their cholesterol levels 2, 5