Cholesterol Testing: the Process Explained

Posted on

Previously published on

High cholesterol is clearly associated with a higher risk of heart disease.  A simple blood test measures four key cholesterol levels to assess risk and whether a statin medication to lower cholesterol is warranted. Getting your cholesterol checked is a simple process with just a few steps.

Who Should Get Their Cholesterol Tested?

The American Heart Association recommends that all adults age 20 and older have a baseline cholesterol test.  And then be tested every five years to note any cholesterol changes.

There are four groups of adults who need their cholesterol checked more frequently than every five years: those with total cholesterol of 200 mg/dL or more, men over age 45 and women over age 50, anyone with HDL (good) cholesterol lower than 40 mg/dL and adults who have risk factors for heart disease and stroke other than high cholesterol.

Regarding additional heart disease risk factors, it’s especially important to monitor cholesterol over time if you have a family history of heart disease, are overweight, are physically inactive, and/or have diabetes.

What Is The Cholesterol Test?

The “Fasting Lipoprotein Profile” is a simple blood test – but it’s one that requires fasting (no food or beverages other than water) for 9-12 hours before blood is drawn.  It’s one test, but delivers multiple blood cholesterol measurements.

How Is The Test Performed?

After making an appointment (preferably in the morning because of the fasting requirement), a small amount of blood will be drawn.  It’s then sent to a laboratory for analysis, and a report stating the blood cholesterol levels and how they compare to “goal” will be sent to your doctor.  You can – and should – get a copy of the report for your personal records as well.

Why Is Fasting Required

Though there are some who believe fasting is not required, most in the medical community still order a fasting blood cholesterol test.  According to the AHA’s How To Get Your Cholesterol Tested article, fasting is ‘required’ because, “If you aren’t fasting when the blood sample is drawn, only the values for total cholesterol and HDL cholesterol will be usable. That’s because the amount of LDL (bad) cholesterol level and triglycerides can be affected by what you’ve recently consumed. For more about the new thinking about whether fasting is required, read No More Fasting For A Cholesterol Test? That said, if your doctor has ordered a fasting blood test, be sure to follow the fasting directions.

What Will The Test Results Include?

Four key measures of blood cholesterol will be included in a fasting lipoprotein profile: total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides. For more about what these cholesterol measurements mean and the optimal level for each, see Cholesterol 101: Types of Cholesterol and Goal Levels.


The new cholesterol treatment guidelines introduced in November 2013 may change the goal levels and treatment guidelines for high cholesterol, but the basic fasting lipoprotein profile test remains unchanged.  While the treatment guidelines are being debated, you can review your results with your doctor using both the “old” guidelines” and the new recommendations. What’s important is to have your cholesterol checked so you can assess – and minimize – heart disease risk using one of the treatment guidelines, or both.

Did You Know?

There are other cholesterol measurements that can be derived from these four key cholesterol levels reported in the fasting lipoprotein profile.  For example, non-HDL cholesterol is one your doctor may look at if your triglycerides are between 200 and 500. It’s calculated very simply by subtracting HDL from total cholesterol:

Total cholesterol – HDL = non-HDL cholesterol. You can read more about this on the blog post, Do You Know Your Non-HDL Cholesterol?


Leave a Reply

Your email address will not be published. Required fields are marked *