Triglycerides should be measured after fasting for at least nine hours. Some people with increased triglyceride levels may need treatment with medication. WHEN SHOULD I START LIPID SCREENING? Many expert groups have guidelines for lipid screening, which typically involves a "lipid profile" that includes blood tests to measure cholesterol and triglyceride levels.

The guidelines differ in their recommendations about when to start screening, how frequently you should be screened, and when to stop. Your health care provider can talk with you about your situation and whether and when you should be screened.

An initial screening profile is often measured by the pediatrician during childhood, and should be measured again at age 18 years. Below are some commonly used guidelines.

See 'Other risk factors for cardiovascular disease' above. The optimal time interval between screenings is uncertain. A reasonable approach is to repeat the lipid profile every five years for people who are unlikely to be candidates for treatment based on past results, and more frequently eg, every three years for people who are near or above the threshold for treatment.

There is no specific recommendation to stop screening at a particular age. However, once a person has had a lipid profile with normal results, it is probably of less value to continue screening beyond the age of 65, as lipid levels are less likely to increase after this point.

Information about how to decide on treatment for hyperlipidemia, and the available treatment options, is available separately. Your health care practitioner is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our web site www. Related topics for patients, as well as selected articles written for health care professionals, are also available.

Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: High cholesterol The Basics Patient education: Atherosclerosis The Basics Patient education: Coronary artery disease The Basics Patient education: Diabetes and diet The Basics Patient education: Nonalcoholic fatty liver disease The Basics Patient education: The ABCs of diabetes The Basics Patient education: Medicines after an ischemic stroke The Basics Patient education: Heart attack recovery The Basics Patient education: Medicines after a heart attack The Basics Patient education: Recovery after coronary artery bypass graft surgery The Basics Patient education: Lowering the risk of having a stroke The Basics Patient education: Coronary artery disease in women The Basics Patient education: Can foods or supplements lower cholesterol?

The Basics. Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient education: High cholesterol and lipid treatment options Beyond the Basics Patient education: Type 1 diabetes: Overview Beyond the Basics Patient education: Type 2 diabetes: Overview Beyond the Basics Patient education: Transient ischemic attack Beyond the Basics Patient education: Stroke symptoms and diagnosis Beyond the Basics Patient education: Peripheral artery disease and claudication Beyond the Basics Patient education: Abdominal aortic aneurysm Beyond the Basics Patient education: High blood pressure in adults Beyond the Basics.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Hypertriglyceridemia in adults: Management HDL cholesterol: Clinical aspects of abnormal values Lipid management with diet or dietary supplements Low-density lipoprotein cholesterol lowering with drugs other than statins and PCSK9 inhibitors Lipoprotein a Inherited disorders of LDL-cholesterol metabolism other than familial hypercholesterolemia Screening for lipid disorders in adults Secondary causes of dyslipidemia Statins: Actions, side effects, and administration Treatment of drug-resistant hypercholesterolemia Low-density lipoprotein cholesterol-lowering therapy in the primary prevention of cardiovascular disease Management of low density lipoprotein cholesterol LDL-C in the secondary prevention of cardiovascular disease.

Contributor disclosures are reviewed for conflicts of interest by the editorial group. When found, these are addressed by vetting through a multi-level review process, and through requirements for references to be provided to support the content. Appropriately referenced content is required of all authors and must conform to UpToDate standards of evidence.

Conflict of interest policy. Why UpToDate? Product Editorial Subscription Options Subscribe Sign in. View Topic Loading Font Size Small Normal Large. Patient education: High cholesterol and lipids Beyond the Basics. Formulary drug information for this topic. No drug references linked in this topic.

Find in topic Formulary Print Share. Official reprint from UpToDate ® www. com © UpToDate, Inc. All Rights Reserved. Author: Robert S Rosenson, MD Section Editor: Mason W Freeman, MD Deputy Editor: Sara Swenson, MD. All topics are updated as new evidence becomes available and our peer review process is complete.

Literature review current through: Jan This topic last updated: Jul 12, TYPES OF LIPIDS The term "lipids" includes cholesterol and triglycerides, although there are other types of lipids, too. The Basics Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed.

Patient education: High cholesterol and lipid treatment options Beyond the Basics Patient education: Type 1 diabetes: Overview Beyond the Basics Patient education: Type 2 diabetes: Overview Beyond the Basics Patient education: Transient ischemic attack Beyond the Basics Patient education: Stroke symptoms and diagnosis Beyond the Basics Patient education: Peripheral artery disease and claudication Beyond the Basics Patient education: Abdominal aortic aneurysm Beyond the Basics Patient education: High blood pressure in adults Beyond the Basics Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings.

Hypertriglyceridemia in adults: Management HDL cholesterol: Clinical aspects of abnormal values Lipid management with diet or dietary supplements Low-density lipoprotein cholesterol lowering with drugs other than statins and PCSK9 inhibitors Lipoprotein a Inherited disorders of LDL-cholesterol metabolism other than familial hypercholesterolemia Screening for lipid disorders in adults Secondary causes of dyslipidemia Statins: Actions, side effects, and administration Treatment of drug-resistant hypercholesterolemia Low-density lipoprotein cholesterol-lowering therapy in the primary prevention of cardiovascular disease Management of low density lipoprotein cholesterol LDL-C in the secondary prevention of cardiovascular disease The following organizations also provide reliable health information.

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Show references Moayeri M, et al. Maternal lipid profile and the relation with spontaneous preterm delivery: A systematic review. Archives of Gynecology and Obstetrics. Catapano AL, et al. Faselis C, et al. Is very low LDL-C harmful? Current Pharmaceutical Design. Cenik B, et al. Plasma sterols and depressive symptom severity in a population-based cohort.

PLoS One. Accessed Oct. Merck Manual Professional Version. What your cholesterol levels mean. American Heart Association. Lopez-Jimenez F expert opinion. Mayo Clinic. Rochester, Minn. Olsson AG, et al. Can LDL cholesterol be too low?

Journal of Internal Medicine. Jorgensen D, et al. Higher dietary inflammation is associated with increased odds of depression independent of Framingham Risk Score in the National Health and Nutrition Examination Survey.

Nutrition Research. Products and Services A Book: Mayo Clinic Family Health Book, 5th Edition Nutritional Supplements at Mayo Clinic Store Newsletter: Mayo Clinic Health Letter — Digital Edition.

See also Arcus senilis: A sign of high cholesterol? Birth control pill FAQ Cholesterol medications: Consider the options Cholesterol ratio or non-HDL cholesterol: Which is most important? Cholesterol test kits: Are they accurate? Cholesterol: Top foods to improve your numbers Cholesterol-lowering supplements may be helpful Coconut oil: Can it cure hypothyroidism?

Congenital adrenal hyperplasia Prickly pear cactus Eggs and cholesterol Fasting diet: Can it improve my heart health? Hashimoto's disease HDL cholesterol: How to boost your 'good' cholesterol Herbal supplements and heart drugs High cholesterol High cholesterol in children High cholesterol treatment: Does cinnamon lower cholesterol?

Hypothyroidism: Can calcium supplements interfere with treatment? Hypothyroidism diet Hypothyroidism and joint pain?

Disorders of lipid metabolism. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. US Preventive Services Task Force final recommendation statement. Statin use for the primary prevention of cardiovascular disease in adults: preventive medication.

Updated August 23, Accessed April 9, US Preventive Services Task Force; Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for lipid disorders in children and adolescents: US Preventive Services Task Force recommendation statement. is accredited by URAC, also known as the American Accreditation HealthCare Commission www.

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Conditions Treated A-Z. High Cholesterol. Definition Cholesterol is a fat also called a lipid that your body needs to work properly. Alternative Names Cholesterol - high; Lipid disorders; Hyperlipoproteinemia; Hyperlipidemia; Dyslipidemia; Hypercholesterolemia Causes There are many types of cholesterol.

The ones talked about most are: Total cholesterol -- all the cholesterols combined High density lipoprotein HDL cholesterol -- often called "good" cholesterol Low density lipoprotein LDL cholesterol -- often called "bad" cholesterol For many people, abnormal cholesterol levels are partly due to an unhealthy lifestyle.

Other lifestyle factors are: Being overweight Lack of exercise Some health conditions can also lead to abnormal cholesterol, including: Diabetes Kidney disease Polycystic ovary syndrome Pregnancy and other conditions that increase levels of female hormones Underactive thyroid gland Medicines such as certain birth control pills, diuretics water pills , beta-blockers, and some medicines used to treat depression may also raise cholesterol levels.

They include: Familial combined hyperlipidemia Familial dysbetalipoproteinemia Familial hypercholesterolemia Familial hypertriglyceridemia Smoking does not cause higher cholesterol levels, but it can reduce your HDL good cholesterol.

Exams and Tests A cholesterol test is done to diagnose a lipid disorder. Recommended starting ages are between 20 to 35 for men and 20 to 45 for women.

Adults with normal cholesterol levels should have the test repeated every 5 years. Repeat testing sooner if changes occur in lifestyle including weight gain and diet. Adults with a history of elevated cholesterol, diabetes, kidney problems, heart disease, and other conditions require more frequent testing.

This is the single biggest change you can make to reduce your risk of heart attack and stroke. Eat foods that are naturally low in fat.

These include whole grains, fruits, and vegetables. Use low-fat toppings, sauces, and dressings. Avoid foods that are high in saturated fat. Exercise regularly. Lose weight if you are overweight. Outlook Prognosis High cholesterol levels can lead to hardening of the arteries, also called atherosclerosis.

References Arnett DK, Blumenthal RS, Albert MA, et al. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA.

Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A. Editorial team. Regardless of whether any of these factors are present, a person's risk for developing cardiovascular disease increases with age.

Men have a higher risk than women at any age. Calculating your risk of cardiovascular disease — There are various online calculators that allow you to input information about yourself in order to estimate your risk of developing cardiovascular disease.

Different calculators can give different scores depending on the variables they use in calculating a person's risk. Examples include:.

Your health care provider can help you understand how to use the available calculators to better understand your risk and interpret the results. The term "lipids" includes cholesterol and triglycerides, although there are other types of lipids, too.

Standard lipid blood tests include a measurement of total cholesterol, low-density lipoprotein LDL and high-density lipoprotein HDL cholesterol, and triglycerides. Total cholesterol — A high total cholesterol level can increase your risk of cardiovascular disease.

However, decisions about when to treat high cholesterol are usually based upon the level of LDL or HDL cholesterol rather than the level of total cholesterol see 'LDL cholesterol' below and 'HDL cholesterol' below. In general:. The total cholesterol level can be measured any time of day.

It is not necessary to fast ie, avoid eating before testing. LDL cholesterol — This is sometimes called "bad" cholesterol, as high LDL levels raise your risk of cardiovascular disease.

Some health care providers make decisions about how to treat hyperlipidemia based on the LDL cholesterol level. Your goal LDL cholesterol depends on your overall risk for a cardiovascular event heart attack or stroke.

Several factors affect your personal risk, including whether you have a history of cardiovascular disease and your risk of developing cardiovascular disease in the future based on your age, sex, and other major risk factors see 'Calculating your risk of cardiovascular disease' above.

People at higher risk are often given a lower LDL cholesterol goal. If your health care provider plans to measure your LDL cholesterol level, he or she may ask you to fast avoid eating for nine hours or longer in order to obtain an accurate result.

However, in many cases, your LDL cholesterol can be measured even after you have eaten recently. HDL cholesterol — Not all cholesterol is bad. High levels of HDL "good" cholesterol is often an indicator of a lower risk of cardiovascular disease. There is no treatment that lowers your risk for a cardiovascular event by raising HDL cholesterol.

As with total cholesterol, the HDL cholesterol can be measured with a blood test at any time, regardless of whether you have been fasting. Non-HDL cholesterol — "Non-HDL" cholesterol includes LDL cholesterol as well as other types of plaque-forming lipids that do not fall into these categories.

Non-HDL cholesterol accounts for the cholesterol carried by very low density lipoproteins VLDL , intermediate density lipoproteins IDL , and lipoprotein a. It can be calculated by subtracting HDL cholesterol from total cholesterol.

Since total cholesterol and HDL cholesterol can be measured accurately without fasting, so can non-HDL cholesterol. Non-HDL cholesterol is generally considered a better predictor of cardiovascular risk than LDL cholesterol.

As discussed, the LDL cholesterol goal depends on a number of factors. See 'LDL cholesterol' above. Triglycerides — High triglyceride levels are also associated with an increased risk of cardiovascular disease. Triglyceride levels are divided as follows:. Triglycerides should be measured after fasting for at least nine hours.

Some people with increased triglyceride levels may need treatment with medication. WHEN SHOULD I START LIPID SCREENING? Many expert groups have guidelines for lipid screening, which typically involves a "lipid profile" that includes blood tests to measure cholesterol and triglyceride levels.

The guidelines differ in their recommendations about when to start screening, how frequently you should be screened, and when to stop. Your health care provider can talk with you about your situation and whether and when you should be screened.

An initial screening profile is often measured by the pediatrician during childhood, and should be measured again at age 18 years. Below are some commonly used guidelines. See 'Other risk factors for cardiovascular disease' above. The optimal time interval between screenings is uncertain. A reasonable approach is to repeat the lipid profile every five years for people who are unlikely to be candidates for treatment based on past results, and more frequently eg, every three years for people who are near or above the threshold for treatment.

There is no specific recommendation to stop screening at a particular age. However, once a person has had a lipid profile with normal results, it is probably of less value to continue screening beyond the age of 65, as lipid levels are less likely to increase after this point.

Information about how to decide on treatment for hyperlipidemia, and the available treatment options, is available separately. Your health care practitioner is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our web site www. Related topics for patients, as well as selected articles written for health care professionals, are also available.

Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials.

The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: High cholesterol The Basics Patient education: Atherosclerosis The Basics Patient education: Coronary artery disease The Basics Patient education: Diabetes and diet The Basics Patient education: Nonalcoholic fatty liver disease The Basics Patient education: The ABCs of diabetes The Basics Patient education: Medicines after an ischemic stroke The Basics Patient education: Heart attack recovery The Basics Patient education: Medicines after a heart attack The Basics Patient education: Recovery after coronary artery bypass graft surgery The Basics Patient education: Lowering the risk of having a stroke The Basics Patient education: Coronary artery disease in women The Basics Patient education: Can foods or supplements lower cholesterol?