Coronary risk profile

How the Test is Performed

A blood sample is needed. For information on how this is done, see: Venipuncture.

Your doctor may order only a cholesterol level as the first test, which will measure cholesterol and, sometimes, HDL cholesterol levels. You may not need more cholesterol tests if your cholesterol is in the normal range.

You may also have a lipid (or coronary risk) profile, which includes:

• Low density lipoprotein (LDL or "bad" cholesterol)
• High density lipoprotein (HDL or "good" cholesterol)
• Total cholesterol
• Triglycerides
• Very low density lipoprotein (VLDL cholesterol, though this is often calculated from the triglyceride level)

People who also have high triglyceride levels may get a test called a direct vLDL cholesterol (direct vLDL-C).

Other blood tests, such as C-reactive protein (CRP), may be added to the profile in some laboratories.

How to Prepare for the Test

Often, if you are only having a cholesterol level done, you can eat beforehand.

If you are having a lipid profile, you should not eat or drink anything except water 9 - 12 hours before having your blood drawn.

How the Test Will Feel

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the Test is Performed

Cholesterol blood tests are done to help you and your doctor better understand your risk for heart disease, stroke, and other problems caused by blocked arteries.

ADULTS

Some guidelines recommend having the first cholesterol test done at age 20. Everyone should have their first screening test by age 35 in men, and age 45 in women.

People who have diabetes, heart disease, stroke, or high blood pressure should always have a cholesterol test done, no matter what their age.

Follow-up testing should be done:

• Every 5 years if your results were normal
• More often for people with diabetes, high blood pressure, heart disease, stroke, or blood flow problems to the legs or feet.
• Every year or so if you are taking medications to control high cholesterol.

CHILDREN

Not all experts agree on when to first check cholesterol levels in children.

• Some experts recommend only screening children who have risk factors, such as a family history of high cholesterol or heart attacks before age 55 in men, and before age 65 in women.
• Others recommend screening all children, but the US Preventative Task Force feels there is not enough evidence to recommend for or against cholesterol screening in children.

Normal Results

The ideal values depend on whether you have heart disease, diabetes, or other risk factors. Your health care provider can tell you what your goal should be.

The desired values in most healthy adults are:

• LDL cholesterol: lower than 130 mg/dL (lower numbers are desired)
• HDL cholesterol: greater than 40 - 60 mg/dL (higher numbers are desired)
• Total cholesterol: less than 200 mg/dL (lower numbers are desired)
• Triglycerides: 10 - 150 mg/dL (lower numbers are desired)
• VLDL: 2 - 30 mg/dL

Talk to your health care provider about the ideal levels in children.

For more information, see: Understanding your cholesterol results

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

Abnormal values may be a sign that you are at increased risk for heart disease, stroke, and other problems caused by blocked arteries. If your cholesterol is too high, you may need treatment to lower your cholesterol levels. This may include medicine and lifestyle changes.

Any active illness, such as a flare-up of arthritis, can change your total cholesterol number. If you have had an illness in the 3 months before having this test, you should have this test repeated in 2 or 3 months.

Risks

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Alternative Names

Lipoprotein/cholesterol analysis; Lipid profile; Lipid panel; Hyperlipidemia - testing; Cholesterol and triglyceride test

References

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486-2497. Updated 2004.

Libby P. Lipoprotein disorders and cardiovascular disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 49.

Gennest J, Libby P. Lipoprotein disorders and cardiovascular disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 47.

Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004 Jul 13; 110(2):227-39.

Update Date: 6/3/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.