High Cholesterol

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A simple blood test tells you if you have high cholesterol.

  • A simple cholesterol test can measure total cholesterol and HDL. You can eat before this test. Sometimes doctors do this test first.
  • A lipoprotein analysis, also called a fasting cholesterol test, is a more thorough test. It measures your total cholesterol plus your LDL, HDL, and triglyceride levels. It is called a fasting test because you don't eat for 9 to 12 hours before the test.
  • A direct LDL test measures your LDL level only. You can have this test done at any time, no matter when you last ate.

Your total cholesterol level is important. But your levels of LDL, HDL, and triglycerides help your doctor decide if you need treatment for high cholesterol. Your doctor will also consider your overall health and your risk of heart attack.

What do your cholesterol numbers mean?

The following tables will help you understand the results of your cholesterol tests. All numbers are milligrams per deciliter (mg/dL), but most people just say the numbers.

Total cholesterol

Your total cholesterol number shows if your cholesterol is too high. If you have high cholesterol, your doctor will want to know your LDL and HDL levels before deciding whether you need treatment and what sort of treatment you need.

Total cholesterol
High240 or above
Borderline-high200 to 239
BestLess than 200

LDL (bad) cholesterol

You want your LDL level to be low. But how low your LDL should be depends on your risk of heart attack. This table shows the LDL levels for someone with an average risk of heart attack.

LDL cholesterol
BestBelow 100
Near best100 to 129
Borderline-high130 to 159
High160 to 189
Very high190 and above

Your LDL goal may be lower if your heart attack risk is higher than average. (To find out your risk, see the Interactive Tool: Are You at Risk for a Heart Attack? Click here to see an interactive tool.)

Your doctor will help decide what your LDL goal is and if you need any treatment to lower your LDL. The higher your risk of heart attack, the lower your LDL goal.

HDL (good) cholesterol

You want your HDL level to be high. HDL (good) cholesterol goals are different for men and women. But for everyone, the higher your HDL, the better. HDL over 60 helps protect against a heart attack. HDL below 40 increases your risk of heart problems. A high HDL number can help offset a high LDL number.

HDL cholesterol
Best60 or higher protects against heart disease
Good40 or higher
BadBelow 40

Triglycerides

You want your triglyceride level to be low.

Triglyceride levels
Normal Less than 150
Borderline-high 150 to 199
High 200 to 499
Very high500 or higher

Your risk level

When you visit your doctor to talk about your cholesterol test, you will talk about other things that increase your risk for heart problems. These include:

If your risk is high, or if you already have heart problems, your doctor will be more likely to prescribe medicine along with lifestyle changes. For more information about heart disease, see the topic Coronary Artery Disease.

Other tests

  • You may need other tests to find out if another health problem, such as hypothyroidism, is causing your high cholesterol.
  • A C-reactive protein (CRP) test may be done for some people who are at risk for getting coronary artery disease. A special type of CRP test, the high-sensitivity CRP test, can help find out your chance of having a sudden heart problem, such as a heart attack. This test may be done even if you have a normal or low level of LDL cholesterol.

More information

Early Detection

Some doctors recommend that everyone older than 20 be checked for high cholesterol. How often you need to be checked depends on whether you have other health problems and your overall chance of heart disease. For more information, see:

By: Healthwise StaffLast Revised: April 22, 2011
Medical Review: E. Gregory Thompson, MD - Internal Medicine
Carl Orringer, MD - Cardiology, Clinical Lipidology

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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