Getting Your Cholesterol Checked

High cholesterol usually causes no symptoms, so many people do not know their levels are high. From 2017 to 2020, 86.4 million U.S. adults aged 20 and older had high or borderline-high cholesterol (a total of 200 mg/dL or more), and from 2009 to 2016 about 1 in 5 adolescents had an unhealthy cholesterol measurement. The only way to know is a simple blood test called a lipid profile.

Who should be tested, and how often

Talk with your health care team about your history and how often you need testing. Checks should start early in life:

• children: at least once between ages 9 and 11;
• adolescents: between ages 17 and 21;
• children with obesity or diabetes: possibly more often;
• most healthy adults: every 4 to 6 years;
• people with heart disease, diabetes or a family history of high cholesterol: more often.

The 2018 American College of Cardiology/American Heart Association guidelines base cholesterol management on a person's lifetime cardiovascular risk, whether they are 45 to 75, whether they have diabetes, and other factors. To estimate that risk, clinicians consider other health conditions, treatment for high blood pressure, smoking and other risk factors. Decisions about managing cholesterol should be made together with a health care professional. Many people have never had their cholesterol checked and so do not know whether they are at risk.

What the test measures

A small blood sample shows:

• LDL cholesterol, the "bad" kind, which in high amounts builds up as plaque in the arteries and can lead to heart disease or stroke;
• HDL cholesterol, the "good" kind, which in high amounts lowers the risk of heart disease and stroke;
• triglycerides, a fat the body uses for energy; high triglycerides with low HDL or high LDL raise the risk of heart attack and stroke;
• total cholesterol, based on the HDL, LDL and triglyceride numbers.

CDC explains more about LDL, HDL and triglycerides.

Before the test

You may need to fast — no food or drink — for 8 to 12 hours beforehand. Ask your doctor how to prepare.

What the numbers mean

Your cholesterol numbers are one part of your overall health. Your health care team will consider them alongside your family history, age, sex and habits such as smoking that could raise your risk, and may order a coronary artery calcium scan to understand your risk better. Together, this picture helps decide whether you need lifestyle changes or cholesterol-lowering medicine to reduce your risk of heart disease and stroke. CDC also describes healthy cholesterol levels.

Sources

• Centers for Disease Control and Prevention: "Testing for Cholesterol." The page's stock photograph is not reproduced.