Cholesterol Screening

Your body needs cholesterol to make hormones and to keep your cells healthy. Cholesterol is a waxy, fat-like substance made by the liver and is found in everyone's blood. Your body produces all the cholesterol it needs, so it is not necessary to eat more of it. However many foods, like those from animals such as; meat, poultry, fish and dairy products, contain cholesterol.

Food from plants such as; fruits, vegetables, grains, nuts and seeds do not contain cholesterol. You will be diagnosed with high cholesterol if there is too much of it in your blood. This condition is associated with a greater risk of stroke, heart disease and heart attacks because the extra cholesterol builds up on the inside walls of the arteries. This build-up is called plaque. As plaque gathers, it narrows the arteries and slows down the flow of blood to the heart and brain. This condition is called atherosclerosis, and it is the major cause of heart disease.

Signs and Symptoms of High Cholesterol

High cholesterol rarely causes symptoms. The way to find out if you have this condition is to have a blood test called a lipid profile. The results provide a measure of your total cholesterol and HDL cholesterol.

Your health care provider may also include LDL cholesterol and triglyceride tests, depending on your risk factors. Low-density lipoprotein, or LDL cholesterol, sometimes referred to as "bad" cholesterol, is the kind that clogs your arteries. Triglycerides are another form of fat that is part of your total cholesterol. Increased levels of LDL cholesterol and triglycerides are dangerous to your health.

High-density lipoprotein, or HDL cholesterol, sometimes referred to as "good" cholesterol, sweeps up the LDL cholesterol from your arteries and sends it to your liver. There it can be processed and the excess removed from the body. HDL cholesterol protects you from cholesterol-related diseases including strokes and heart attacks. Higher levels of HDL cholesterol lower your risk of getting heart disease.

Who Should Be Screened

  • If you already have diabetes, high cholesterol or heart disease, you should get your total cholesterol, including HDL, LDL and triglycerides, checked frequently as recommended by your health care team.
  • If you are a man age 35 or older you should have your total cholesterol and HDL levels checked every five years.
  • If you are a man between the ages of 20 and 35 and have increased risk for coronary heart disease, you should get checked every five years or more frequently as advised by your health care team.
  • If you are a woman age 20 or older with an increased risk for coronary heart disease, you should be checked every five years.

Factors shown to increase the risk of developing coronary heart disease include:

  • Having a family history of coronary disease or stroke
    • Before age 50 in a male relative, or
    • Before age 60 in a female relative
  • Tobacco use
  • High blood pressure
  • Decreased physical activity
  • Obesity

Ask your health care provider if you should have your cholesterol checked more frequently than every five years.

Diagnosis and Treatment of High Cholesterol

For total cholesterol, the ideal level is under 200. Borderline high is between 200 and 239. High cholesterol is over 240.

For LDL cholesterol, under 100 may be best but each person is different and should discuss this with their health care provider.

  • 100 - 129 is above optimal
  • 130-159 is borderline high
  • 160 - 189 is high, and
  • 190 and above is very high

For HDL cholesterol, 60 and above is considered protective against heart disease. Less than 40 is a major risk factor for heart disease.

Your triglyceride level should be under 150. Borderline high is between 150 and 199. A high triglyceride level is above 200.

Treatment depends on your test results as well as your risk for cholesterol-related diseases. Those at the highest risk need the most aggressive treatment. Medications may be needed for higher risk individuals or those with higher cholesterol levels if lifestyle changes are not successful. People with few or no risk factors can proceed more conservatively. You should discuss treatment options with your health care provider.

Eating a healthy diet, quitting smoking, and losing excess weight is recommended no matter what your cholesterol level. Your diet should include eating more;

  • Fruits and vegetables
  • High-fiber bread and cereals
  • Whole grains and Oats
  • Dried beans and peas

Limit or avoid foods containing saturated fat, cholesterol and trans fats, such as;

  • Packaged crackers, chips, or cookies
  • Chicken with the skin
  • Fatty or red meat
  • Egg yolks
  • Deep fried foods
  • High-fat cheeses and
  • Whole milk dairy products

Being physically active can have a significant impact on high cholesterol-related risk factors by helping you lose weight and increasing your HDL cholesterol.

What We Have Learned

Cholesterol in your blood comes from your body and foods you eat.
True or False
The answer is True

High cholesterol places you at risk for diseases including heart disease and strokes. LDL cholesterol increases these risks while HDL cholesterol decreases risk.
True or False
The answer is True

Smoking will raise your risk of having cholesterol-related disease, including heart disease and stroke.
True or False
The answer is True