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Cholesterol testing

Cholesterol is a soft, wax-like substance found in all parts of the body. Your body needs a small amount of cholesterol. Too much cholesterol can clog your arteries and lead to heart disease, stroke, and other problems.

Some types of cholesterol are considered "good" and some are considered "bad." Different blood tests are used to measure each type.

A coronary risk profile is a group of blood tests that measure your cholesterol and triglyceride levels. The profile can help determine your risk for heart disease.

How is the Test Performed?

A blood sample is needed. Most of the time blood is drawn from a vein located on the inside of the elbow or the back of the hand.

You may only have your total cholesterol level measured as the first test. This may include measurement of your HDL cholesterol levels. You may not need more cholesterol tests if your cholesterol is in the normal range.

You may also have a lipid (or coronary risk) profile, which includes:

  • Low density lipoprotein (LDL or "bad" cholesterol)
  • High density lipoprotein (HDL or "good" cholesterol)
  • Total cholesterol
  • Triglycerides
  • Very low density lipoprotein (VLDL cholesterol, though this is often calculated from the triglyceride level)

People who also have high triglyceride levels may get a test called a direct VLDL cholesterol (direct VLDL-C).

Other blood tests, such as C-reactive protein (CRP), may be added to the profile in some labs.

Preparation for the Test

If you are having only a cholesterol level test, you may not be able to eat before the test.

If you are having a lipid profile, you should not eat or drink anything except water 9 to 12 hours before having your blood drawn.

How the Test will Feel

You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.

Why is the Test Performed?

Cholesterol blood tests help you and your doctor better understand your risk for heart disease, stroke, and other problems caused by blocked arteries.

Everyone should have their first screening test by age 35 for men, and age 45 for women. Some guidelines recommend starting at age 20.

People who have diabetes, heart disease, stroke, high blood pressure, or a strong family history of heart disease should have a cholesterol test done at an earlier age.

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
  • More often if you are taking medications to control high cholesterol

Normal Results for Cholesterol testing

The desired values in most healthy adults without risk factors for heart disease are:

  • LDL cholesterol: lower than 130 mg/dL
  • HDL cholesterol: greater than 40 to 60 mg/dL (higher numbers are desired)
  • Total cholesterol: less than 200 mg/dL
  • Triglycerides: 10 to 150 mg/dL
  • VLDL: 2 to 30 mg/dL

The ideal values for you depend on whether you have heart disease, diabetes, or other risk factors.

  • Learn more about what your cholesterol levels mean for you.
  • Ask your doctor what your goal should be.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

Abnormal values may be a sign that you are at higher risk for heart disease, stroke, and other problems caused by blocked arteries caused by blocked arteries.

If you have diabetes, heart disease, or risk factors for heart disease, LDL cholesterol levels as low as 70 to 100 mg/dL can lower your risk for heart disease and related problems.

If your cholesterol is too high, you may need treatment to lower your cholesterol levels.

  • Lowering your cholesterol begins with lifestyle changes.
  • Some people will need to take medicine to lower their cholesterol.


Gennest J, Libby P. Lipoprotein disorders and cardiovascular disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 47.

Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz N, Lloyd-Jones DM, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. JACC. In press.

American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37 Suppl 1:S14-S80.

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Review Date: 5/5/2013
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update: 05/14/14
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