What are the cholesterol test types?

Cholesterol is a type of fat molecule, and cholesterol testing measures how much of it is present in the blood. Testing can help evaluate heart health since excess cholesterol is a risk factor for cardiovascular problems like heart disease and stroke.

There are multiple types of cholesterol, often categorized as either “good” or “bad.” A total cholesterol test measures the sum of good and bad cholesterol. While total cholesterol can be tested on its own, it is more often integrated into the lipid panel test that also shows the levels of each type of cholesterol.

What Are Cholesterol Tests？

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

Your provider may order only a total cholesterol level as the first test. It measures all types of cholesterol in your blood.

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

• 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)

Lipoproteins are made of fat and protein. They carry cholesterol, triglycerides, and other fats, called lipids, in the blood to various parts of the body.

When Should You Be Cholesterol Tested?

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

You should have a cholesterol test done at an earlier age if you have:

• Diabetes
• Heart disease
• Stroke
• High blood pressure
• A strong family history of heart disease

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.
• Every year or so if you are taking medicines to control high cholesterol.

DEMOGRAPHIC GROUP	RISK FACTORS	SCREENING FREQUENCY
Children	None	Once between ages 7-11; again between 17-21
Children	1 or more	Every 1-3 years starting when risk factor is identified
Children	High risk of familial hypercholesterolemia	Age 3, between 9-11, and age 18
Adolescents and adults	1 or more	At least every 5 years; often annually
Men age 20-45 Women age 20-55	None	Every 5 years
Men age 45-65 Women age 55-65	None	Every 1-2 years
Men and women over 65	None or risk factors present	Annually

What Are The Cholesterol Test Types?

Total Cholesterol Test

A total cholesterol of 180 to 200 mg/dL (10 to 11.1 mmol/l) or less is considered best.

You may not need more cholesterol tests if your cholesterol is in this normal range.

LDL (Bad) Cholesterol Test

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

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

Your LDL is most often considered to be too high if it is 190 mg/dL or higher.

Levels between 70 and 189 mg/dL (3.9 and 10.5 mmol/l) are most often considered too high if:

• You have diabetes and are between ages 40 and 75
• You have diabetes and a high risk of heart disease
• You have a medium or high risk of heart disease
• You have heart disease, history of a stroke, or poor circulation to your legs

Health care providers have traditionally set a target level for your LDL cholesterol if you are being treated with medicines to lower your cholesterol.

Some newer guidelines now suggest that providers no longer need to target a specific number for your LDL cholesterol. Higher strength medicines are used for the highest risk patients.

However, some guidelines still recommend using specific targets.

HDL (Good) Cholesterol Test

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 40 to 60 mg/dL (2.2 to 3.3 mmol/l) are desired.

VLDL (Bad) Cholesterol Test

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 from 2 to 30 mg/dL (0.1 to 1.7 mmol/l).

Cholesterol Test Results

In the United States, cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. In Canada and many European countries, cholesterol levels are measured in millimoles per liter (mmol/L). To interpret your test results, use these general guidelines.

Total cholesterol(U.S. and some other countries)	Total cholesterol*(Canada and most of Europe)
Below 200 mg/dl	Below 5.18 mmol/L	Desirable
200-239 mg/dl	5.18-6.18mmol/L	Borderline high
240 mg/dl  and above	Above 6.18 mmol/L	High

 

LDL cholesterol(U.S. and some other countries)	LDL cholesterol*(Canada and most of Europe)
Below 70 mg/dl	Below 1.8 mmol/L	Best for people who have coronary artery disease — including a history of heart attacks, angina, stents or coronary bypass.
Below 100 mg/dl	Below 2.6 mmol/L	Optimal for people at risk of coronary artery disease or who have a history of diabetes. Near optimal for people with uncomplicated coronary artery disease.
100-129 mg/dl	2.6-3.3 mmol/L	Near optimal if there is no coronary artery disease. High if there is coronary artery disease.
130-159 mg/dl	3.4-4.1 mmol/L	Borderline high if there is no coronary artery disease. High if there is coronary artery disease.
160-189 mg/dl	4.1-4.9 mmol/L	High if there is no coronary artery disease. Very high if there is coronary artery disease.
190 mg/dl and above	Above 4.9 mmol/L	Very high.

 

HDL cholesterol(U.S. and some other countries)	HDL cholesterol*(Canada and most of Europe)
Below 40 mg/dl , menBelow 50 mg/dl, women	Below 1 mmol/L, menBelow 1.3 mmol/L, women	Poor
40-59 mg/dl, men50-59 mg/dl, women	1-1.5 mmol/L, men1.3-1.5 mmol/L, women	Better
60 mg/dl and above	Above 1.5 mmol/L	Best

 

Triglycerides(U.S. and some other countries)	Triglycerides*(Canada and most of Europe)
Below 150 mg/dl	Below 1.7 mmol/L	Desirable
150-199 mg/dl	1.7-2.2 mmol/L	Borderline high
200-499 mg/dl	2.3-5.6 mmol/L	High
500 mg/dl and above	Above 5.6 mmol/L	Very high

 

Canadian and European guidelines differ slightly from U.S. guidelines. These conversions are based on U.S. guidelines.

If your results show that your cholesterol level is high, don't get discouraged. You might be able to lower your cholesterol with lifestyle changes, such as quitting smoking, exercising and eating a healthy diet.

If lifestyle changes aren't enough, cholesterol-lowering medications also might help. Talk to your doctor about the best way for you to lower your cholesterol.

Can I Take The Cholesterol Test At Home?

Two main types of at-home cholesterol tests are available:

• Test kits that have you take a blood sample from your finger and send it by mail to a lab.
• Test kits that include an at-home method for analyzing the blood sample from your finger. This may be a small electronic device or a test strip that changes color to indicate cholesterol levels.

At-home tests for total cholesterol may include other cholesterol measurements, such as HDL and LDL, that are part of a typical lipid panel.

While at-home testing may be convenient, there are a few downsides.  Mistakes can be made in the sample collection process, leading to inaccurate results.  Additionally, most kits only measure total cholesterol and aren’t able to distinguish between LDLs and HDLs.

References：

1. Cholesterol test - Mayo Clinic

2. Cholesterol Levels: MedlinePlus Medical Test

See also:

1. Cholesterol care