How Can I Work Out If I Am At Risk Of Heart Disease
A heart risk assessment will help you find out your risk of heart disease by building a picture of your risk based on factors such as your age, sex, ethnicity, cholesterol levels, smoking history, blood pressure, family history and other health conditions.Different people need a heart risk assessment at different ages. Find out more about heart risk assessment.
How Often Should Cholesterol Be Checked
The American Heart Association recommends that all adults 20 or older have their cholesterol and other traditional risk factors checked every four to six years as long as their risk remains low. After age 40, your health care professional will also want to use an equation to calculate your 10-year risk of having a heart attack or stroke.
People with cardiovascular disease, and those at elevated risk, may need their cholesterol and other risk factors assessed more often.
Your doctor will explain what your cholesterol levels mean and can discuss treatment options if your numbers are not where they should be.
What Do These Numbers Even Mean
After the test, youll take a look at your total lipid profile. Your doctor will explain whether your results appear normal, at-risk, or high.
These are the adult recommendations, according to the American Heart Associations 2018 guidelines. All values are in mg/dL :
Total cholesterol: All the cholesterol found in your blood
- Good: below 200
Triglycerides: A major type of fat in the body
- Good: below 149
- Borderline: 150 to 199
- High: 200+
- Very high: 500
Folks with conditions like diabetes might need to shoot for lower numbers, so chat with your doctor to know whats right for you. Cholesterol guidelines also vary by age: Kids should have lower levels than adults.
If your numbers are in the at-risk zone, your doctor may recommend lifestyle changes to lower them.
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Low Density Lipoprotein Bad Cholesterol
High levels are linked to an increased risk of heart and blood vessel disease, including coronary artery disease, heart attack and death. Reducing LDL levels is a major treatment target for cholesterol-lowering medications.
Goal values:
- Less than 70 mg/dL for those with heart or blood vessel disease and for other patients at very high risk of heart disease
- Less than 100 mg/dL for high risk patients
- Less than 130 mg/dL for individuals who are at low risk for coronary artery disease
Preparation:
Blood should be collected after a 12-hour fast . For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check LDL levels.
LDL is a lipoprotein found in the blood. It is called “bad” cholesterol because it picks up cholesterol from the blood and takes it to the cells. A high LDL level is related to a higher risk of heart and blood vessel disease.
What To Expect During The Test
A cholesterol test is a simple blood test during which a technician will generally seat the person in a chair with a special armrest. The technician will then tie a rubber strip around the persons arm to try to find a suitable vein from which to draw blood.
After finding a vein, the technician will clean the area with alcohol, insert a needle attached to a tube into the persons vein, and allow the tube to fill.
When the tube is full of blood, the technician will remove the needle and hold gauze on the site of the puncture. The technician may ask the person to apply pressure for a few minutes to stop the bleeding, and they might apply a small bandage over the gauze.
At this point, the test is complete, and the person is usually free to go about their normal daily activities.
The results will tell a doctor if the levels of cholesterol in a persons blood are healthy.
The test measures several types of cholesterol in a persons blood in mg/dl. It is possible to break down the results by type of cholesterol.
HDL cholesterol
HDL results measure the amount of good cholesterol in a persons blood. Higher readings tend to be better than lower readings:
| 60 mg/dl or higher |
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Getting A Cholesterol Test
We recommend that all adults should get a cholesterol check no matter what your age or how healthy you feel.
The only way to know your cholesterol levels is to get a check. High cholesterol doesn’t usually have any signs or symptoms and it can be caused by your genes as well as your lifestyle, so we advise getting a check even if you are young, fit and feel healthy.
A cholesterol check involves a simple blood test.
Your doctor should also check another blood fat called triglycerides, as these also affect your heart health.
A test will show you if you need to make healthy changes. High cholesterol can lead to heart attacks and strokes. A cholesterol test, along with other simple tests including a blood pressure test, BMI and waist measurement, will give you a good idea of your heart health and show you if you need to make any lifestyle changes or need treatment.
How Do I Prepare For My Cholesterol Test
If your doctor recommends a “non-fasting” cholesterol test, the lab will look only at your total cholesterol numbers. For that test, you merely need to show up at the lab and have some blood drawn. If your doctor suggests a “fasting” cholesterol test , the lab will analyze your levels of LDL, HDL, triglycerides, and total cholesterol. For that test, you will need to fast nine to 12 hours before the blood test.
Sometimes a doctor will ask you to do a non-fasting cholesterol test first. Depending on the results, they may then send you back for the more complete lipid profile.
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Why Would I Need This Test
You might need this test if your doctor wants to assess your risk of developing heart disease. It is usually recommended every 5 years for people who are over 45 . If you have other risk factors for heart disease such as high blood pressure or diabetes, you will need the lipid test more regularly.
What Does A Cholesterol Test Measure
In addition to measuring the total cholesterol in your blood, the standard cholesterol test measures three specific kinds of fat:
- Low-density lipoproteins . This is the “bad cholesterol,” the main cause of plaque build-up, which increases your risk for heart disease. In general, the lower the number, the better. But LDL cholesterol is only one part of a larger equation that measures a personâs overall risk of having a heart attack or stroke. For years, guidelines focused on specific target numbers for individuals to achieve to lower their risk. The most recent guidelines focus on a personâs overall risk and, based on that risk, recommend a certain percentage of LDL reduction as one part of a strategy for preventing serious heart and vascular problems.
- High-density lipoproteins . This is the “good cholesterol.” It transports bad cholesterol from the blood to the liver, where it is excreted by the body. Your HDL is another part of the equation that identifies the risk of a cardiovascular event. In general, the higher the number the better, although, as with LDL, the emphasis has shifted from specific target numbers to strategies for reducing the overall risk.
- Triglycerides. Another type of fat in the bloodstream, triglycerides are also linked to heart disease. They are stored in fat cells throughout the body.
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What Does An At
At-home cholesterol tests can measure the total amount of cholesterol in a blood sample and may also determine the levels of specific kinds of cholesterol.
Cholesterol and other fat-like substances are known as lipids. To travel through the blood, lipids must attach to particles called lipoproteins, which are made up of a mix of proteins and fat.
Cholesterol can attach to different kinds of lipoproteins, and this is a primary way of distinguishing between types of cholesterol. A lipid panel is a kind of cholesterol test that evaluates several types of lipids. The standard components of a lipid panel include:
- Total cholesterol:Total cholesterol is the sum of all types of cholesterol found in a blood sample.
- High-density lipoprotein cholesterol: Also known as good cholesterol, HDL cholesterol contributes to cardiovascular health in several ways, including by reducing the unwanted buildup of cholesterol in arteries.
- Low-density lipoprotein cholesterol: Commonly referred to as bad cholesterol, LDL cholesterol is linked to cardiovascular problems like heart disease and stroke. In most cases, LDL-C is calculated using an equation based on the other measurements in a lipid panel.
- Triglycerides: Triglycerides are another type of fat that have been associated with cardiovascular problems.
Cholesterol Tests And Heart Attack Risk
Your cholesterol levels can help your doctor find out your risk for having a heart attack or stroke.
But it’s not just about your cholesterol. Your doctor uses your cholesterol levels plus other things to calculate your risk. These include:
- Your blood pressure.
- Whether or not you have diabetes.
- Your age, sex, and race.
- Whether or not you smoke.
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Why Do I Need To Fast Before My Blood Test
If your health care provider has told you to fast before a blood test, it means you should not eat or drink anything, except water, for several hours before your test. When you eat and drink normally, those foods and beverages are absorbed into your bloodstream. That could affect the results of certain types of blood tests.
Are Test Results Accurate
Cholesterol testing is common and generally dependable as part of cardiovascular risk assessment. Like any medical testing, though, cholesterol tests are not perfect.
When properly performed, at-home cholesterol self-tests can be about as accurate as laboratory lab tests conducted with a blood draw. However, products that are poorly manufactured or that provide inadequate instructions may suffer from reductions in accuracy.
For both in-lab and at-home cholesterol measurement, certain issues can influence the accuracy of the test:
- Individual factors: Small fluctuations in cholesterol levels can be related to stress or your physical posture during the test.
- Active illness: Inflammation related to various types of illness can change cholesterol levels, affecting the short-term reliability of cholesterol measurements.
- LDL-C calculations: Standard cholesterol testing usually calculates LDL-C levels based on the other measurements. The formulas for these calculations can lead to inaccurate results in people who have very high triglyceride levels.
For any questions about the accuracy of specific at-home tests, you can ask the test provider for available documentation related to the testing method and results accuracy. Your doctor can also discuss any factors in your case that could affect cholesterol test results.
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Is There Anything Else I Need To Know About Fasting Before A Blood Test
Be sure to talk to your health care provider if you have any questions or concerns about fasting.
You should talk to your provider before taking any lab test. Most tests don’t require fasting or other special preparations. For others, you may need to avoid certain foods, medicines, or activities. Taking the right steps before testing helps ensure your results will be accurate.
The Deal With Ldl Testing
A lipid test involves taking a blood sample from a vein, typically in the arm.
Afterward, youll need to press down on the site with gauze or a bandage for 2 minutes or so. Then you can go about your day as usual. You should feel little to no pain or discomfort.
Your doctor will send over your lab results in about 24 hours.
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When Should I Have A Cholesterol Check
We believe all adults should know their cholesterol numbers, no matter what your age. Even if you havent been invited for a cholesterol check its a good idea to get one anyway because its the only way to know your cholesterol numbers.
You should also be offered a free cholesterol test by the NHS if any of the following apply to you:
-
You are aged 40-74
Your GP should invite you for an NHS health check once every five years from the age of 40 to 74. The NHS health check is designed to spot the early signs of heart disease, stroke, kidney disease, diabetes and dementia. Youll be weighed and measured, have a cholesterol check and a blood pressure check, and youll be asked some simple questions about your health.
-
You are at high risk of heart disease
Your GP or practice nurse might also offer you a cholesterol test if you are more likely to develop heart disease. For example, if other people in your family have had it, you smoke, youre overweight, or you have high blood pressure, diabetes or certain other health problems.
Fasting And Cholesterol Tests
For many years, fasting prior to cholesterol tests was recommended in every case. However, increasingly, doctors are reconsidering this recommendation. Research suggests that food intake doesnt affect the accuracy of measurements for total cholesterol, HDL, and LDL.
That said, food before a test can elevate triglyceride levels, so accuracy there does require fasting. Prior to your test, double-check with your doctor about how best to prepare.
Cholesterol tests provide a broader glimpse of your health status. You cant really affect results without making significant, long-term dietary or lifestyle changes . As such, behaviors like steering clear of foods high in cholesterol or saturated fat within a couple of days of your lipid profile wont really affect results.
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High Density Lipoprotein Good Cholesterol
High levels linked to a reduced risk of heart and blood vessel disease. The higher your HDL level, the better.
Goal value:
- Greater than 40 mg/dL
Preparation:
This test may be measured any time of the day without fasting. However, if the test is drawn as part of a total lipid profile, it requires a 12-hour fast . For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check HDL levels.
HDL is a lipoprotein found in the blood. It is called “good” cholesterol because it removes excess cholesterol from the blood and takes it to the liver. A high HDL level is related to lower risk of heart and blood vessel disease.
What To Expect During A Test For Triglycerides
Your doctor can measure your triglyceride levels using a simple blood draw. The process is the same if the test is measuring your fasting or nonfasting triglyceride levels. If your doctor wants to measure your fasting triglyceride levels, they will likely instruct you to fast for a given amount of time. They may also ask you to avoid certain medications.
If the test is measuring nonfasting triglycerides, there are typically no dietary restrictions. However, your doctor may request that you avoid eating a meal thats unusually high in fat prior to the test.
If you have a history of fainting during blood draws, notify the lab technician who will be collecting your sample.
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Foods To Lower Cholesterol
The foods a person consumes can affect their cholesterol levels over time.
Some foods can help reduce cholesterol. For example, soluble fiber can bind with cholesterol in the digestive system and from the body. Additionally, polyunsaturated fats can help lower LDL levels.
According to Harvard Health, a person should aim to include the following in their diet:
- barley
Why You Should Measure Your Cholesterol
While cholesterol is essential for your health, if it gets too high it might increase your risk of heart disease putting you at risk of things like a heart attack or stroke.
There are a number of things that can raise your cholesterol to an unhealthy level:
- eating foods high in cholesterol, saturated fats, and trans fats can increase your levels
- lack of exercise
- drinking too much alcohol
- a genetic condition called familial hypercholesterolaemia
There arent any signs of high cholesterol until something goes wrong, like a heart attack. So measuring your cholesterol levels regularly is recommended.
Regular cholesterol tests are particularly important if you:
- are overweight or obese
- have a family history of high cholesterol or heart disease
- have high blood pressure, coronary artery disease, or diabetes
- are on medication for high cholesterol and need to track your levels
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When To Get Tested
Screening: as part of a regular health exam with a lipid profile when no risk factors for heart disease are present adults should be tested once every four to six years children, teens, and young adults should be tested once between the ages of 9 and 11 and then again between the ages of 17 and 21.
Monitoring: may be done more frequently and at regular intervals when risk factors for heart disease are present, when prior results showed high risk levels, and/or when undergoing treatment for unhealthy lipid levels
An End To The Dreaded Overnight Fast
Guidelines for lipid panels have evolved over the past decade, supported by evidence from studies involving hundreds of thousands of people. Most recommendations now support non-fasting cholesterol tests for routine testing.
Some fasting lipids tests will remain necessary, especially in people with very high triglycerides. And some people will still need to fast for blood sugar levels, although an alternative test for diabetes has replaced much of this testing. But for most, including those having routine cholesterol tests to weigh cardiovascular risk and for those taking drug therapy, this news is good news.
So ask your doctor if you really need to skip breakfast before your next blood draw. Traditions die hard, but both science and convenience may ultimately steer this one to its end. This is one change doctors and patients should celebrate together.
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