Blood Cholesterol Diagnosis
Your doctor will diagnose you with high blood cholesterol based on your medical and family history, a physical exam, and a blood test of your cholesterol levels.
Medical history and physical exam
Your doctor will ask about your eating habits, physical activity, family history, medicines you are taking, and risk factors for heart or blood vessel diseases.
During your physical exam, your doctor will check for signs of very high blood cholesterol, such as xanthomas, or signs of other health conditions that can cause high blood cholesterol.
Screening for high cholesterol
Your doctor may order a blood test called a panel to screen for unhealthy cholesterol levels.
Lipoprotein (lipid) panel
A lipoprotein panel, also called a lipid panel or lipid profile, measures the levels of LDL and HDL cholesterol and triglycerides in your blood. Cholesterol and triglyceride levels that are higher or lower than normal may be signs of higher risk of coronary heart disease.
A lipoprotein panel gives information about your:
- Total cholesterol
- LDL ("bad") cholesterol, which is the main source of cholesterol buildup and blockages in the arteries
- HDL ("good") cholesterol, which helps decrease cholesterol blockages in the arteries
- Triglycerides, which are a type of fat in your blood
Most people will need to fast for 9 to 12 hours before a lipoprotein panel.
How often you get a lipid panel done depends on your age, risk factors, and family history of high blood cholesterol or cardiovascular diseases, such as , heart attack or stroke.
Here is a general guide:
- Age 19 or younger: Screening begins at ages 9 to 11 and should be repeated every 5 years. Screening may be performed as early as age 2 if there is a family history of high blood cholesterol, heart attack, or stroke.
- Age 20 to 65: Younger adults should be screened every 5 years. Men ages 45 to 65 and women ages 55 to 65 should be screened every 1 to 2 years.
- Older than 65: Older adults should be screened every year.
If your blood cholesterol levels are not within the healthy range for your age and sex, your doctor may order a repeat lipid profile test, especially if you were not fasting before your first lipid panel. Also, it is important to know that your risk of coronary heart disease and stroke is based on several other factors, not just your cholesterol levels. These factors include things like your age, race, and lifestyle habits.
Lipoprotein-a
A lipoprotein-a, or Lp(a), test is not usually part of a routine lipid panel. High levels of Lp(a) may mean you are at high risk of heart or blood vessel diseases, even if your other cholesterol levels are healthy. The genes you inherit from your parents determine how much Lp(a) you have. Your Lp(a) level is unlikely to change much from childhood to old age.
Your doctor may order an Lp(a) test if you have a family history of early heart disease, such as a heart attack, or do not know your family medical history. If you have a high Lp(a) level, your doctor may prescribe a , a medicine to help prevent heart disease, even if your other cholesterol levels are in the healthy range.
Find out what your cholesterol numbers mean and use a tool to estimate the risk of having a heart attack.