Cholesterol Tests

(Lipid tests)

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Definition | Body Parts Involved | Reasons for Procedure | Complications | What to Expect | Outcome | Call Doctor If

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Definition

Blood tests that measure the levels of cholesterol in your blood. The following cholesterol tests measure the three main components of cholesterol:

Total cholesterol test - Measures the total level of cholesterol in your blood

Total and HDL-cholesterol test - Measures the levels of total cholesterol and HDL ("good") cholesterol in your blood

Lipoprotein profile -Measures the levels of total cholesterol, HDL- cholesterol, LDL ("bad") cholesterol, and triglycerides in your blood

Parts of the Body Involved

Arm

Reasons for Procedure

The levels of cholesterol in your blood play an important role in determining your risk of cardiovascular disease (CVD), particularly coronary heart disease (CHD). High LDL-cholesterol levels increase the risk of CHD, while high HDL-cholesterol levels decrease the risk. Which test your doctor recommends will depend on your risk factors for CHD.

Risk Factors for Complications during the Procedure

Collecting blood from a vein carries minimal risk. Some people may develop a bruise or a small collection of blood under the skin at the site of the needle stick, this is called a hematoma. The chance of a hematoma developing is greater for people taking aspirin or other blood-thinning medications (i.e., Coumadin).

What to Expect

Prior to the Procedure -Your preparation varies depending on which test you are having

• For a total cholesterol test and total cholesterol test with HDL measurement, you do not have to fast.
• For a lipoprotein profile, you will have to fast (have nothing to eat or drink but water, coffee, or tea, with no cream or sugar, for 9 to 12 hours before the test).
• For either test, your doctor may instruct you not to take certain medications that may affect cholesterol levels.

During the Procedure - A blood sample is taken from a vein in your arm

Anesthesia - None

After the Procedure:

• Resume your normal diet.
• Resume taking medications, as instructed by your doctor.
• If a hematoma develops, apply firm pressure to the area using a piece of cotton under a well-secured, large band-aid.

Description of the Procedure - You roll up your sleeve and the nurse or lab technician who is drawing your blood ties a tourniquet around your upper arm. Then he or she inserts a needle into a vein in your arm near the inside of your elbow and draws a small amount of blood into a vial. The blood sample is then sent to a laboratory for testing.

How Long Will It Take? Drawing the blood sample takes approximately three minutes. Laboratory testing time varies depending on the laboratory. Results are generally available within in a few days or a week.

Will It Hurt? It may hurt slightly as the needle is inserted into your arm.

Possible Complications:

• A small bruise or hematoma at the site where the needle was inserted into your arm
• Feeling lightheaded (this is easily treated by eating some food or drinking juice)
• Rarely, lightheaded patients may faint

Average Hospital Stay - None. This test is performed in your doctor's office or in a clinic or hospital laboratory.

Outcome

If you have never had heart disease If your total cholesterol and HDL-cholesterol levels are in the desirable range (less than 200 mg/dL, and greater than 40 mg/dL respectively), there is usually no need for further testing for another five years. If your results fall outside this range, your doctor may recommend a lipoprotein profile depending on your other risk factors for heart disease.

If your total cholesterol is above 240 mg/dL, your doctor will most likely recommend a lipoprotein profile regardless of your HDL level or CHD risk.

If you have heart disease Your doctor will perform a lipoprotein profile rather than a total cholesterol or HDL-cholesterol test.

Results of the lipoprotein profile The lipoprotein profile will help guide your doctor's treatment and follow-up recommendations. Depending on your LDL-cholesterol level and other CHD risk factors, your doctor may advise lifestyle changes with or without cholesterol-lowering medications.

This chart explains how to interpret results:

Interpreting the results of cholesterol tests

Total Cholesterol
Desirable	Less than 200 mg/dL*
Borderline high	200 to 239 mg/dL
High	240 mg/dL and above
Low Density Lipoprotein (LDL)
Optimal	Less than 100 mg/dL
Near or above optimal	100 to 129 mg/dL
Borderline high	130 to 159 mg/dL
High	160 to 189 mg/dL
Very high	190 mg/dL and above
High Density Lipoprotein (HDL)
Protective effect against heart disease	60 mg/dL and above
Healthy range, but higher is better	40 to 59 mg/dL
Major risk factor for heart disease	Less than 40 mg/dL
Triglycerides
Normal	Less that 200 mg/dL
Borderline-High	200 to 400 mg/dL
High	400 to 1000 mg/dL
Very high	1000 mg/dL and above

Note: These categories apply to adults age 20 and older

*mg/dL = milligrams per deciliter of blood

Call Your Doctor If Any of the Following Occurs

• You have a hematoma at that site of the needle stick that appears to be growing larger
• You do not hear from your doctor's office regarding your test results within a few weeks

SOURCES:

National Heart, Lung, and Blood Institute

Illustrated Guide to Diagnostic Tests, Springhouse Corporation, 1994

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Last reviewed February 2001 by Medical Review Board