Cholesterol: Different Types, Different Tests
As we grow older, it isn’t uncommon for our physicians to grade our health by looking at test numbers and scores. Blood pressure numbers measure our heart rate while it’s working and at rest. BMI, which stands for body mass index, is a ratio of our height and weight. And then there is cholesterol.
While most people over the age of 20 have likely had cholesterol screening bloodwork, many are in the dark about what the numbers mean and why they are important.
And with good reason. Experts themselves can’t agree on what the numbers should be and what they really mean for our overall health.
The Good, the Bad and the Confusing Information about Cholesterol
Experts from Harvard Medical School are some of the leading authorities on cholesterol research. They tell us an overall score of 200 or less for total cholesterol puts you in the healthy category. If you’re at 200-239, that’s a borderline score that might be considered troubling to your physician. Once you reach 240, you earn the dubious honor of having high cholesterol.
But it’s also important to know how your total score breaks down by each type of cholesterol. There are two different kinds:
- LDL: Low-density lipoprotein cholesterol is known as “bad” cholesterol. Too much bad cholesterol can clog blood vessels in the heart. A diet high in saturated and trans fat can raise bad cholesterol levels. Physicians try to work with patients to help them keep their LDL at 100 or less. (This number was revised from a recommendation of 70 in 2004.)
- HDL: High-density lipoprotein cholesterol is the “good” type of cholesterol. An HDL greater than 60 is believed to help protect you from heart disease, while a score of 40 or less puts you at risk.
- Another part of cholesterol blood testing measures triglycerides. They are a type of fat found in your blood. The body uses them for energy. Some triglycerides are necessary for maintaining heart health, but too much can put you at risk for heart disease.
When Do You Start and How Often Should You Have a Cholesterol Test?
Most people wonder at what age they should begin cholesterol testing and how often they should be tested. Unfortunately, the answer isn’t a simple one.
Many experts recommend anyone over the age of 20 should be screened, and that testing should be repeated every 4 to 6 years unless they fall into a high risk category. Others say screening should begin in the teenage years.
Physicians typically take a variety of factors into consideration when making this determination including:
- Family history
- High blood pressure
In general, the American Heart Association recommends adults over the age of 20 who haven’t been diagnosed with cardiovascular disease have a cholesterol screening test every four to six years. For those with higher risk factors, this number should be increased.
To Fast or Not to Fast
Most physicians require patients fast for at least nine hours prior to having a blood test to measure their cholesterol. In fact, current guidelines from the American College of Cardiology state fasting is the “preferred” method. This is despite growing evidence that shows no significant difference between having the test on a full stomach or on one that is empty.
The bottom line is to work closely with a trusted physician to help screen and manage your numbers.
Have you had your cholesterol checked lately? What are some of the things you’ve done to manage it? Let us know in the comments below.