From the Guidelines
Routine cholesterol screening is generally recommended every 5 years for adults with normal risk factors, but the most recent and highest quality study suggests that the optimal intervals for cardiovascular risk assessment are uncertain, and reasonable options include annual assessment of blood pressure and measurement of lipid levels every 5 years 1.
Key Considerations
- For adults aged 20 and older with no cardiovascular disease risk factors, screening every 5 years is sufficient.
- Those with risk factors such as family history of heart disease, high blood pressure, diabetes, smoking, or obesity should be screened more frequently, typically every 1-2 years.
- Men should begin regular screening by age 35, while women should start by age 45, though earlier screening is advised for those with risk factors.
- After age 65, annual screening is often recommended as cardiovascular risk increases with age.
- Children and adolescents with family history of high cholesterol or early heart disease should be screened between ages 9-11 and again between 17-21, as recommended by the expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents 1.
Screening Intervals
- The optimal screening interval is uncertain, but reasonable options include every five years, shorter intervals for persons who have lipid levels close to those warranting therapy, and longer intervals for low-risk persons who have had low or repeatedly normal lipid level measurements 1.
- The most recent study suggests that periodic assessment of cardiovascular risk factors from ages 40 to 75 years, including measurement of total cholesterol, LDL-C, and HDL-C levels, is required to implement this recommendation 1.
Important Factors
- Treatment decisions should take into account overall risk of heart disease rather than lipid levels alone.
- Overall risk assessment should include the presence and severity of the following risk factors: age, gender, diabetes, elevated blood pressure, family history (in younger adults), and smoking 1.
- The screening typically measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides to provide a comprehensive picture of cardiovascular risk.
From the Research
Recommended Time Intervals for Routine Cholesterol Screening
The recommended time intervals for routine cholesterol screening vary based on age and risk factors.
- Adults aged 20 and older should have their total and high-density lipoprotein cholesterol measured, as elevated cholesterol levels raise the risk of coronary heart disease (CHD) in men and women and in younger and older adults 2.
- Adults are advised to have their cholesterol checked at least once every 5 years to identify persons who may be at risk for developing coronary heart disease 3, 4.
- The American Heart Association recommends that children older than 3 years of age should have a cholesterol test, and advice regarding avoidance of high-risk coronary life-style behaviors should be a routine part of pediatric anticipatory guidance 5.
- However, some studies suggest that cholesterol screening in young adults should be limited to individuals with known coronary disease or other unusual factors that place them at high short-term risk of CHD death, as the cost-effectiveness and potential harm of intervention in this population are concerns 6.