Diagnosis

Blood tests can easily measure cholesterol levels. A blood test for cholesterol should include the entire lipoprotein profile: LDL, total cholesterol, HDL, and triglycerides. It is very difficult to measure LDL levels by themselves, but LDL levels can be reliably calculated using total cholesterol and HDL levels.

To obtain a reliable cholesterol reading, doctors advise:

• Avoid strenuous exercise for 24 hours before the test.
• Do not eat or drink anything but water for 12 hours beforehand.
• If the test results are abnormal, a second test should be performed between 1 week and 2 months after the first test.

Screening Guidelines

Periodic cholesterol testing is recommended in all adults, but the major national guidelines differ on the age to start testing.

• Recommended starting ages are between 20 - 35 for men and 20 - 45 for women.
• Adults with normal cholesterol levels do not need to have the test repeated for 5 years unless changes occur in lifestyle (including weight gain and diet).
• Adults with a history of elevated cholesterol, diabetes, kidney problems, heart disease, and other conditions require more frequent testing.

Screening with a fasting lipid profile is recommended for children who:

• Have risk factors such as a family history of high cholesterol, and history of heart attacks before age 55 for men and before age 65 for women. Screening should begin as early as age 2 and no later than age 10.
• Are obese (above 85th percentile for weight) or who have diabetes. If the child’s cholesterol level tests normal, retesting is recommended in 3 - 5 years.

Patients already being treated for high cholesterol should be checked every 2 - 6 months.

Review Date: 04/06/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)