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Cholesterol Tests
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Cholesterol Tests

(Lipid Tests)

En Español (Spanish Version)

Definition

Blood tests that measure the levels of cholesterol in your blood. The following cholesterol tests measure the components of cholesterol:

  • Total cholesterol test—measures the total level of cholesterol in your blood
  • Total and HDL-cholesterol test—measures the levels of total cholesterol and HDL ("good") cholesterol in your blood and may include a ratio of total cholesterol to HDL-cholesterol
  • Lipoprotein profile—measures the levels of total cholesterol, HDL-cholesterol, LDL ("bad") cholesterol, and triglycerides in your blood
  • Triglycerides—elevated triglycerides do not cause heart attacks by themselves, but are a risk factor for heart disease if the other cholesterol components are abnormal

LDL Particles, Small LDL, IDL, Lipoprotein A, and HDL subtypes are tests that are currently being studied for cholesterol measurement and management

Parts of the Body Involved

  • Arm
  • Vein

Reasons for Procedure

The levels of cholesterol in your blood play an important role in determining your risk of cardiovascular disease (CVD), particularly coronary heart disease (CHD). High LDL-cholesterol levels increase the risk of CHD, while high HDL-cholesterol levels decrease the risk. Which test your doctor recommends will depend on your risk factors for CHD.

Risk Factors for Complications During the Procedure

Collecting blood from a vein carries minimal risk. Some people may develop a bruise or a small collection of blood under the skin at the site of the needle stick, called a hematoma. (A bruise is usually a small amount of blood whereas a hematoma is a larger amount of bleeding under the skin.) The chance of a hematoma developing is greater for people taking aspirin or other blood-thinning medications (ie, Coumadin).

Plaque Formation in Blood Vessel—Side Effect of High HDL Cholesterol

Plaque

© 2008 Nucleus Medical Art, Inc.

What to Expect

Prior to the Procedure

Your preparation varies depending on which test you are having.

  • For a total cholesterol test and total cholesterol test with HDL measurement, you do not have to fast.
  • For a lipoprotein profile, you will have to fast (have nothing to eat or drink but water, coffee, or tea, with no cream or sugar, for 9-12 hours before the test).
  • Prior to either test, your doctor may instruct you not to take certain medications that may affect blood cholesterol levels.

Description of the Procedure

The nurse or lab technician will tie a tourniquet around your upper arm. A needle is inserted into a vein in your arm near the inside of your elbow and draws a small amount of blood into a vial. The blood sample is then sent to a laboratory for testing.

Anesthesia

Anesthesia is not needed for this procedure.

After the Procedure

  • Resume your normal diet.
  • Resume taking medications, as instructed by your doctor.
  • If a hematoma develops, apply firm pressure to the area using a piece of cotton under a well-secured, large band-aid.

How Long Will It Take?

Drawing the blood sample, from start to finish, takes approximately three minutes. Laboratory testing time varies depending on the laboratory. Results are generally available within in a few days or a week.

Will It Hurt?

It may hurt slightly as the needle is inserted into your arm.

Possible Complications

  • A small bruise or hematoma at the site where the needle was inserted into your arm
  • Feeling lightheaded, which is easily treated by lying down or eating some food or drinking juice
  • Rarely, lightheaded patients may faint

Average Hospital Stay

None. This test is performed in your doctor's office, a clinic, or hospital laboratory.

Outcome

If You Have Never Had Heart Disease:

If your total cholesterol and HDL-cholesterol levels are in the desirable range (less than 200 mg/dL [5.2 mmol/L], and greater than or equal to 60 mg/dL [1.6 mmol/L] respectively), there is usually no need for further testing for another five years. If your results fall outside this range, your doctor may recommend a lipoprotein profile depending on your other risk factors for heart disease. Testing might also be recommended more often than every five years.

If your total cholesterol is above 240 mg/dL (6.2 mmol/L), considered a high level, your doctor will most likely recommend a lipoprotein profile regardless of your HDL level or CHD risk.

If You Have Heart Disease:

Your doctor will perform a lipoprotein profile rather than a total cholesterol or HDL-cholesterol test. The frequency of testing will depend on the advice of your physician.

Results of the Lipoprotein Profile:

The lipoprotein profile will guide your doctor's treatment and follow-up recommendations. Depending on your lipid levels and other CHD risk factors, your doctor may advise lifestyle changes with or without use of cholesterol-lowering medications.

This chart explains how to interpret results:

Interpreting the Results of Cholesterol Tests

Total Cholesterol
DesirableLess than 200 mg/dL* (5.2 mmol/L)
Borderline high200-239 mg/dL (5.2-6.1 mmol/L)
High240 mg/dL (6.2 mmol/L) and above
Low Density Lipoprotein (LDL)
OptimalLess than 100 mg/dL (2.6 mmol/L)
Near or above optimal100-129 mg/dL (2.6-3.3 mmol/L)
Borderline high130-159 mg/dL (3.3-4.0 mmol/L)
High160-189 mg/dL (4.0-4.8 mmol/L)
Very high190 mg/dL (4.9 mmol/L)and above
High Density Lipoprotein (HDL)
Desirable60 mg/dL (1.5 mmol/L) and above
Normal40-59 mg/dL (1.0-1.5 mmol/L)
LowLess than 40 mg/dL (1.0 mmol/L)
Triglycerides
NormalLess that 150 mg/dL (1.7 mmol/L)
Borderline-High150-199 mg/dL (1.6-2.2 mmol/L)
High200-499 mg/dL (2.3-5.6 mmol/L)
Very high500 mg/dL (5.7 mmol/L) and above

Note: These categories apply to adults aged 20 and older

*mg/dL = milligrams per deciliter of blood (mmol/L= millimoles per liter of blood)

Call Your Doctor If Any of the Following Occurs

  • At the site of the needle stick, you have a hematoma that appears to be growing larger
  • You do not hear from your doctor's office regarding your test results within a few weeks

RESOURCES:

American Heart Association
http://www.americanheart.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca

University of Ottawa Heart Institute
http://www.ottawaheart.ca/UOHI/Welcome.do

References:

Akosah KO, Schaper A, Cogbill C, Schoenfeld P. Preventing myocardial infarction in the young adult in the first place: how do the National Cholesterol Education Panel III guidelines perform? J Am Coll Cardiol. 2003 May 7;41(9):1475-9.

National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/.

Illustrated Guide to Diagnostic Tests. 1994 National Cholesterol Education Program ATP III Guidelines. Springhouse Corporation; 2001 May.

Law MR, Wald NJ. Risk factor thresholds: their existence under scrutiny. Br Med J. 2002 Jun 29;324(7353):1570-6.



Last reviewed March 2008 by Jill Landis, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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