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Get your copy of Diagnosis: Coronary Artery Disease
This report helps you identify the risk factors you can control, which range from medical conditions such as high blood pressure to lifestyle choices such as an unhealthy diet or lack of exercise. You'll learn about the steps you can take to eliminate or at least manage these risks. A Special Bonus Section on cardiac rehabilitation explains what to expect from these heart-healing programs, which can reduce deaths by up to 25% during the years following a heart attack or heart procedure. This report also describes the latest improvements in diagnosis and treatment—including medications and surgical procedures—so that you are aware of your options and can talk with your doctor about them.
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Your cholesterol test: What happens during and after?
How much cholesterol you have floating around in your blood—and what types—can help you figure out your risk for heart disease. So it's important to get your cholesterol tested periodically. How often you should get tested depends on your risk for heart disease. Are you at low risk for heart disease? Then you need a test every five years. If you're at higher risk, you'll need a test every two years. Ask your doctor which group you fall into.
Getting a cholesterol test is easy. All you need to do is have a tube's worth of blood drawn from your arm during a visit to your physician. The preparation, however, takes a little more effort. Food and drinks affect your cholesterol profile, so you have to fast for 12 hours to get accurate readings of your LDL ("bad" cholesterol), HDL ("good" cholesterol), and triglyceride levels. You also need to avoid drinking alcohol for at least 24 hours before the test.
After your blood is drawn, a technician measures your total cholesterol, HDL, and triglyceride levels. Your LDL level is typically calculated from these results. However, as of 2009, some labs routinely measure LDL levels directly.
Understanding your test results
After you get the results of your fasting cholesterol test, compare them with the National Cholesterol Education Program guidelines for healthy levels (see table, below).
| Quick guide to cholesterol and triglyceride levels |
| Total cholesterol level | Total cholesterol category |
| Less than 200 mg/dL | Desirable |
| 200–239 mg/dL | Borderline high |
| 240 mg/dL and above | High |
| LDL cholesterol level | LDL cholesterol category |
| Less than 100 mg/dL (less than 70 mg/dL for people at high risk) | Optimal |
| 100–129 mg/dL | Near optimal/above optimal |
| 130–159 mg/dL | Borderline high |
| 160–189 mg/dL | High |
| 190 mg/dL and above | Very high |
| HDL cholesterol level | HDL cholesterol category |
| Less than 40 mg/dL | Low (representing risk) |
| 60 mg/dL and above | High (heart-protective) |
| Triglyceride level | Triglyceride category |
| Less than 150 mg/dL | Normal |
| 150–199 mg/dL | Borderline high |
| 200–499 mg/dL | High |
| 500 mg/dL and above | Very high |
| Adapted from the 2004 Report of the National Cholesterol Education Program. |
What to tell your doctor after a cholesterol test
When discussing your cholesterol test results with your doctor, be sure to tell him or her if any of these three things apply to you:
- Did you have the flu or another illness shortly before the blood test? These events can have a dramatic effect on your cholesterol levels.
- Was your diet very different than normal in the weeks leading up to the cholesterol test? If so, tell your doctor. High levels of alcohol or carbohydrates can raise triglycerides.
- Did you forget to fast or sneak something to eat or drink before the test? Don't be embarrassed to say so. Otherwise, you could end up on a medication you don't need.
What next?
If your total cholesterol, LDL cholesterol, or triglycerides are borderline high, high, or very high, you and your doctor will talk about how to get your levels lower. Treatment may include:
- changing your diet
- exercising more
- taking a cholesterol medication
- a combination of all of the above.
Before deciding on a treatment plan, though, your doctor will want to get a good picture of your heart health. He or she will likely check:
- Your blood pressure, to make sure it is in a healthy range.
- Your pulse, to make sure that your heartbeat is regular and forceful.
- The size of your thyroid gland, which can be determined by feeling your neck. An underactive or overactive thyroid can affect cholesterol levels.
- The pulses of the carotid arteries in your neck. Listening to the blood flow there can rule out any blockages.
- The pulses in your legs, which can fade away if there are significant blockages in any of the arteries that go to the feet.
If your doctor is concerned about anything he or she sees during the physical exam, you may be sent for lab tests or imaging procedures. These could include:
- An electrocardiogram (ECG)
- A chest x-ray
- An echocardiogram (ultrasound picture of the heart)
- Tests of thyroid or kidney function
- Ultrasounds of the legs
With the results from your cholesterol test, your physical, and any lab or imaging tests you needed, your doctor will be able to recommend how you should treat your cholesterol levels and lower your risk of heart disease.
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