Cholesterol testing and results

Some types of cholesterol are considered good and some are considered bad. Different blood tests can be done to measure each type of cholesterol.

To measure your cholesterol levels, you will have a lipid (or coronary risk) profile, also called a lipid panel. Lipids, or lipoproteins, are made of fat and protein. They carry cholesterol, triglycerides, and other lipids in the blood to various parts of the body.

A lipid panel includes the following tests:

• Total cholesterol
• Low density lipoprotein (LDL cholesterol)
• High density lipoprotein (HDL cholesterol)
• Triglycerides (another type of fat in your blood)
• Very low density lipoprotein (VLDL cholesterol, not always reported in a lipid panel)

All adults should also have their lipoprotein (a), or Lp(a), tested once in their lifetime. This is a separate test, it is not part of the lipid profile.

The American College of Cardiology/American Heart Association guidelines call for everyone to have their first lipid profile by age 19. Children ages 9 to 11 years old should have their cholesterol tested once to check for familial hypercholesterolemia or other lipid problems.

Follow-up testing should be done:

• Every 5 years if your results were normal.
• More often for people with diabetes, high blood pressure, heart disease, stroke, or blood flow problems to the legs or feet.
• As your provider recommends if you are taking medicines to lower your cholesterol.

A total cholesterol of less than 200 mg/dL (5.18 mmol/L) is considered best (lower numbers are better).

LDL cholesterol is sometimes called "bad" cholesterol. LDL can clog your arteries.

You want your LDL to be low. Having too much LDL is linked to heart disease and stroke.

Your LDL goal is based on your risk for heart disease and whether you have health conditions that increase your risk:

• LDL under 100 mg/dL (2.59 mmol/L) if you are borderline or moderate risk and do not have diabetes or heart disease (primary prevention)
• LDL under 70 mg/dL (1.81 mmol/L) if you are at high risk, have diabetes, or have other risk factors (primary prevention)
• LDL under 55 mg/dL (1.42 mmol/L) if you have had a heart attack or stroke (secondary prevention)

Your provider will help you understand your long-term risk for heart disease and what your LDL goal should be.

You want your HDL cholesterol to be high. Studies of both men and women have shown that the higher your HDL, the lower your risk of coronary artery disease. This is why HDL is sometimes referred to as "good" cholesterol.

HDL cholesterol levels greater than 60 mg/dL (1.55 mmol/L) are desired, though even higher is better.

VLDL contains the highest amount of triglycerides. VLDL is considered a type of bad cholesterol because it helps cholesterol build up on the walls of arteries.

Normal VLDL levels are less than 30 mg/dL (0.78 mmol/L).

Your Lp(a) level is something you inherit through your genes. A high Lp(a) level can increase your risk for heart attack and stroke.

Lp(a) levels of 125 nmol/L or 50 mg/dL and above are considered high.

There are other tests your provider may recommend that can further reveal your risk for heart disease:

Apolipoprotein B (ApoB) is a type of protein that can cause plaque to build up in your arteries. Your provider may recommend this test if you have high triglycerides, diabetes, or metabolic syndrome.

C-reactive protein (CRP) is produced by the liver. Higher levels of CRP are a sign of inflammation in your body that puts you at risk for heart disease. Your provider may recommend this test under certain circumstances.

Coronary artery calcium (CAC) scan is a scan of your heart that shows if you have a buildup of calcium in your coronary arteries. You may receive this test if you are at high risk or have symptoms of heart disease.

Cholesterol test results; LDL test results; VLDL test results; HDL test results; Coronary risk profile results; Hyperlipidemia-results; Lipid disorder test results; Heart disease - cholesterol results; Lipid panel

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Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.