Cholesterol Testing And Interpretation: Understanding Levels For Better Health

Table of contents

  1. Introduction
  1. What does the test measure
  1. Procedure
  1. Understanding and interpreting the results
  1. Taking actions
  1. Conclusion

Key takeaways

  • Understanding your cholesterol test results, including total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and other markers, provides valuable insights into your cardiovascular health.
  • Regular cholesterol testing is essential for monitoring heart health and assessing your risk of heart disease.
  • Open communication with your healthcare provider is crucial for developing a personalized plan to manage cholesterol levels and reduce heart disease risk.


Welcome to our blog, where we're delving into a topic crucial for your heart's well-being: cholesterol testing. While it might sound like a routine medical check, understanding cholesterol and its impact on your heart health can be a game-changer in preventing serious cardiovascular diseases.

While your body needs some cholesterol to build healthy cells, too much of it can lead to trouble. Excess cholesterol can build up in your arteries, forming plaques that narrow or block blood flow. This process, known as atherosclerosis, significantly increases your risk of coronary artery diseases, heart attacks, and strokes.

Getting tested for cholesterol is like giving your heart a check-up. It provides valuable insights into your heart health and allows you to make informed decisions about your lifestyle and medical care. Remember, knowledge is power, and by knowing your cholesterol levels, you're taking a proactive step towards a healthier heart and a brighter future.

What does the test measure?

A complete cholesterol test, also known as a lipid profile, is a blood test that checks the levels of cholesterol and triglycerides in your blood.  

Its purpose is to determine if your cholesterol levels are elevated and to gauge your risk of heart attacks, and other vascular conditions. This comprehensive test evaluates different blood parameters, including:

  • Total cholesterol: This estimates the total amount of cholesterol present in your bloodstream. Lower values are preferable.  
  • Normal: Less than 200 mg/dL
  • Borderline high: 200 to 239 mg/dL
  • High: At or above 240 mg/dL
  • Low-density lipoprotein (LDL) cholesterol: Often referred to as bad cholesterol, high levels of LDL cholesterol can lead to the formation of fatty deposits (plaques) in your blood vessels, restricting blood flow and increasing the risk of heart attacks and strokes. Elevated levels are associated with increased risk.
  • Target goal: less than 70 mg/dL
  • Average risk: 100 mg/dL or less
  • Near-optimal: 100-129 mg/dL
  • Borderline high: 130-159 mg/dL
  • High risk: 160 mg/dL and above
  • High-density lipoprotein (HDL) cholesterol: Known as the good cholesterol, HDL helps remove LDL cholesterol from your arteries, promoting better blood flow and reducing the risk of cardiovascular issues. Higher values are considered protective against heart disease.
  • The normal value should be ideally 50-60 mg/dL
  • Triglycerides: These are a type of fat, primarily derived from excess calories. Elevated triglyceride levels are associated with various factors like obesity, unhealthy diet, excessive alcohol consumption, smoking, physical inactivity, or uncontrolled diabetes.  Lower is better.  
  • Optimal: Less than 150 mg/dL  
  • Borderline risk: 151-199 mg/dL
  • High risk: over 200 mg/dL
  • Very Low-Density Lipoprotein (VLDL) cholesterol: It is a type of lipoprotein that carries triglycerides from the liver to other parts of the body. Elevated levels of VLDL are associated with an increased risk of cardiovascular disease as they contribute to the buildup of plaque in the arteries, similar to LDL cholesterol.  
  • A normal VLDL level is below 30 mg/dL.
  • Total cholesterol/HDL cholesterol ratio: It provides insight into the balance between bad and good cholesterol in the bloodstream. A higher ratio indicates a greater risk of heart disease, as it suggests a higher proportion of harmful cholesterol relative to protective cholesterol.  
  • Maintaining a lower value, ideally below 3.5:1, is associated with better heart health.
  • LDL/HDL ratio: A high ratio suggests a greater presence of bad cholesterol compared to good cholesterol, indicating an elevated risk of heart disease development.  
  • The normal ranges are below 3.0 for men and below 2.5 for women.  
  • Non-HDL cholesterol: This measures LDL, VLDL, and remnants of other cholesterol-carrying molecules. Elevated numbers indicate an increased risk of heart disease.
  • An ideal level for most individuals is below 130 mg/dL, although for those with a history of heart attack, a lower level may be recommended.  

Why is cholesterol testing important?

  • You might find it necessary to undergo this panel of tests if there's a family history of heart disease or stroke.  
  • Your healthcare provider might recommend these tests if they perceive you to be at risk for heart disease due to factors such as high blood pressure, diabetes, being overweight, smoking, lack of exercise, consuming an unhealthy diet, etc.  
  • If you're already receiving treatment for heart disease or high cholesterol levels, these tests can help assess the effectiveness of the treatment.

How frequently should I have my cholesterol levels checked?

Your healthcare provider will determine the frequency of your cholesterol checks based on several factors, including your age, family history of heart disease, and risk factors for heart disease.  

  • As you age, the frequency of cholesterol checks may increase.  
  • Those with a family history of heart disease or with diagnosed risk factors may need more frequent tests.

The Lipid Association of India recommends regular lipid profile screenings starting at age 20 for all individuals, and as early as age two for those with a family history of high cholesterol or premature coronary heart disease in men under 55 years and women under 65 years.  

Do you need to fast?

Yes, fasting is required for a lipid profile test, and it's usually recommended to fast for at least 10 to 12 hours before the test. Fasting entails abstaining from eating or drinking anything except water during this period. Fasting is necessary because the levels of certain lipids, particularly triglycerides, can be influenced by recent food intake. By fasting, the test results provide a more accurate reflection of your baseline lipid levels, allowing healthcare providers to assess your cardiovascular risk more effectively.  

Some medications, such as corticosteroids, diuretics, beta-blockers, and certain birth control pills, can affect your lipid levels. It's crucial to ask your healthcare provider in advance about whether fasting is necessary for your specific test. Always adhere to the instructions provided by your healthcare provider. If you accidentally break the fast by consuming food, inform your provider because the test may not be as useful without proper fasting.  

What happens during the test?

During the lipid profile test, a blood sample is collected usually from a vein in your arm. The procedure involves a healthcare professional cleansing the site with an antiseptic, and then inserting a small needle to draw the blood into a tube. While some individuals may experience slight discomfort or a pinching sensation during the needle insertion, the process is generally quick and minimally uncomfortable. After the blood is collected, the needle is removed, and a bandage is placed over the puncture site to stop any bleeding.  

Advanced lipid profile

Advanced lipid testing, also known as expanded lipid panel testing, provides more detailed information about your cholesterol levels and cardiovascular risk beyond standard lipid profile results. It includes additional tests that measure specific cholesterol particles, lipoproteins, and other markers associated with heart disease.

Advanced lipid testing proves particularly beneficial for individuals with diabetes, insulin resistance, or cardiovascular disease who experience continued progression of heart disease despite achieving target levels for LDL and total cholesterol. This includes tests such as Apolipoprotein A (ApoA), apolipoprotein B (ApoB), and particle size testing.

Advanced Lipid Profile

Taking action based on results

If your cholesterol test results fall outside the desired ranges, don't worry. Your healthcare provider will discuss personalized recommendations tailored to your specific health needs and risk factors. These recommendations may include lifestyle changes such as adopting a heart-healthy diet, increasing physical activity, quitting smoking, or medications if necessary. It's essential to follow your doctor's guidance to improve your cholesterol levels and reduce your risk of heart disease effectively.  


In conclusion, maintaining optimal cholesterol levels is paramount for heart health and overall well-being. Regular cholesterol testing is a crucial step in understanding your risk of heart disease and taking proactive measures to protect your cardiovascular health. By scheduling regular check-ups with your healthcare provider, you can monitor your cholesterol levels and make informed decisions about your health. Additionally, open communication with your doctor is key to developing a personalized plan for managing cholesterol and reducing heart disease risk.  

To further support your health journey, consider downloading the Aware Health Rewards app. Manage cholesterol levels through health insights, delivered as daily action steps. Optimize your heart health with a daily Heart Score and Free Heart Attack Risk Assessment. Together, let's prioritize heart health and pave the way for a happier, healthier future.

About the Author

Dr. Satish Madiraju, a renowned cardiologist is passionate about consumer heart health and is on a mission to prevent a million heart attacks. He shares his expertise not only on heart health but also on leadership, digital health, and improving patient experience.
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