High cholesterol by itself usually has no signs or symptoms. A complete cholesterol test is done to determine whether your cholesterol is high and estimate your risk of developing heart disease.
A complete cholesterol test, referred to as a lipid panel or lipid profile, includes the calculation of four types of fats (lipids) in your blood:
- Total cholesterol. This is a sum of your blood's cholesterol content.
- High-density lipoprotein (HDL) cholesterol. This is sometimes called the "good" cholesterol because it helps carry away LDL cholesterol, thus keeping arteries open and your blood flowing more freely.
- Low-density lipoprotein (LDL) cholesterol. This is sometimes called the "bad" cholesterol. Too much of it in your blood causes the buildup of fatty deposits (plaques) in your arteries (atherosclerosis), which reduces blood flow. These plaques sometimes rupture and can lead to a heart attack or stroke.
- Triglycerides. Triglycerides are a type of fat in the blood. When you eat, your body converts any calories it doesn't need into triglycerides, which are stored in fat cells. High triglyceride levels are associated with several factors, including being overweight, eating too many sweets or drinking too much alcohol, smoking, being sedentary, or having diabetes with elevated blood sugar levels.
Who should get a cholesterol test?
All adults age 20 or older should have a cholesterol test once every five years. Ideally, you should begin having your cholesterol checked during your early 20s. You should have your cholesterol measured when you're relatively healthy. An acute illness, a heart attack or severe stress can affect cholesterol levels.
Cholesterol testing is especially important if you:
- Have a family history of high cholesterol or heart disease
- Are overweight
- Are physically inactive
- Have diabetes
- Eat a high-fat diet
- Are a man older than 45 or a woman older than 55
These factors put you at increased risk of developing high cholesterol and heart disease.
If you have high cholesterol levels, your doctor may want you to get tested more often. Discuss with your doctor how often you should have a cholesterol test if your cholesterol levels are abnormal.
Also, if you have a strong family history of early heart disease, your doctor may want to test other risk factors, such as lipoproteins, that aren't part of the standard cholesterol profile.
Cholesterol is often high during pregnancy, so pregnant women should wait at least six weeks after giving birth to have their cholesterol measured. The same is true for people who've been ill or had a heart attack, surgery or an accident.
Some drugs are known to increase cholesterol levels, including anabolic steroids, beta blockers, epinephrine, oral contraceptives and vitamin D. Be sure the doctor who orders your tests is aware of all the drugs and supplements you're taking.
Children and cholesterol testing
Children as young as age 2 can have high cholesterol, but not all children need to be screened for high cholesterol. The American Academy of Pediatrics recommends a cholesterol test only for children between the ages of 2 and 10 who have a known family history of high cholesterol or premature coronary artery disease. Your child's doctor may recommend retesting if your child's first test shows he or she has abnormal cholesterol levels. If you have a family history of coronary artery disease that develops at a young age, your doctor may recommend more frequent cholesterol tests beyond the recommended screenings.
The American Academy of Pediatrics also recommends testing if the child's family history for high cholesterol is unknown, but the child has risk factors for high cholesterol, such as obesity, high blood pressure or diabetes.