Understanding Cholesterol Tests

Published on May 20, 2022

High cholesterol levels increase the risk of blocks within the blood vessels, and could result in a heart attack or stroke. The lipid profile test is a blood test that is advised every 4 to 6 years for those who are not at a risk for cardiovascular disease, and more often in the others.

The lipid profile test estimates several parameters such as the HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol and triglycerides. These molecules contain fats. While some of the parameters are measured from the blood sample, others are calculated based on the measured values.

HDL-cholesterol versus the others

The HDL-cholesterol is often referred to as the ‘good cholesterol’. A low level of HDL-cholesterol is associated with an increase in cardiovascular risk. This is in contrast to other cholesterol molecules, where low levels are desirable. To separate the good from the undesirable, the HDL-cholesterol levels are subtracted from the total cholesterol levels. This parameter, referred to as the non-HDL cholesterol, is a better indicator of the harmful cholesterol levels compared to the total cholesterol levels.

The Non-HDL cholesterol molecules

The non-HDL cholesterol molecules includes the LDL-cholesterol, VLDL-cholesterol and the triglycerides. Among these, the LDL-cholesterol level is considered an important risk factor for cardiovascular disease. High triglyceride levels are usually accompanied by high LDL-cholesterol levels or low HDL-cholesterol levels. Very high triglyceride levels could increase the risk of inflammation of the pancreas.

Treatment of high cholesterol levels

Treatment decisions to lower cholesterol levels are usually taken based on the LDL-cholesterol levels. Physicians use cholesterol-lowering medications to control the LDL-cholesterol levels and therefore prevent cardiovascular disease. If the triglyceride levels remain high despite treatment with these medicines, diet control and physical activity, additional medications may be prescribed.

Reference:

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). Available at https://www.nhlbi.nih.gov/files/docs/guidelines/atp3xsum.pdf

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