What is Cholesterol Screening?

A cholesterol screening examines a patient for lipid disorders, coronary heart disease, and other signs and risks for cardiovascular disease. Cholesterol screening is used for preventative healthcare, assessing the risk for heart disease and then treating the risk factor. High blood cholesterol can lead to a hardening of the arteries and an increase in the likelihood of heart attacks and heart disease. If a cholesterol screening reveals that there is a high level of blood cholesterol, a doctor can then prescribe medications and recommend a change in diet to lower it.

Cholesterol is a lipidic, or fatty, waxy alcohol made in the liver and used in cell membranes to maintain proper cell permeability. It is transported through the bloodstream within lipoproteins, a protein with a lipid soluble inside and hydrophilic outside. Cholesterol is found in food products such as dairy, eggs, and meat and is necessary in small amounts for healthy bodily function. Cholesterol helps the body build cell membranes, synthesize steroid hormones, and create the bile that breaks down fats. Too much, however, can lead to several health problems.

A cholesterol screening measures the amount of lipoproteins in the body, especially low density lipoproteins (LDL) and high density lipoproteins (HDL). LDL is usually considered “bad cholesterol.” Too much LDL causes an accumulation of plaque along the walls of blood vessels and can eventually narrow the vessel enough to impede blood flow to the heart. This can also cause the hardening of the arteries, known as atherosclerosis, which is closely associated with coronary heart disease, peripheral vascular disease, heart attack, or stroke. HDL carry cholesterol to the liver to be excreted, and so high amounts of HDL are considered good for health.

A cholesterol screening will be on the lookout for high LDL, low HDL, triglycerides, another type of fat transported by very low density lipoproteins (VLDL), as well as total cholesterol level. This is called a lipoprotein profile and is achieved through a blood test. In addition to the blood test, the doctor will also do a physical examination, taking blood pressure, heart rate, and checking the heart beat. The doctor will also discuss the patient’s medical history, which is important because much of a person’s lipoprotein balance is determined by genetics. The balance can also be altered by diet, medications, pregnancy, and exercise.

It is recommended that everyone over the age of twenty should get a cholesterol screening every five years, and men over thirty-five and women over forty-five should have themselves routinely tested. The lipoprotein profile will have numbers for LDL cholesterol count, HDL cholesterol, triglycerides, and total cholesterol. Less than 100 is optimal for LDL and above about 140 is high. HDL numbers below 40 for women and 50 for men are considered a risk for heart disease and above 60 is considered healthy. Triglycerides should be under 150 and it is recommended that total cholesterol be under 200.

If it is found that the patient has low HDL and high LDL, triglycerides, and total cholesterol, the doctor may recommend several courses of action depending on the patient’s medical history and how high the cholesterol is. Weight loss, quitting smoking, exercise, and diet, particularly cutting down meats, dairy, and eggs, are common treatments. If the risk factors persist, a doctor may also prescribe a medication, which will either be statin, a bile acid sequestrant, a cholesterol absorption inhibitor, niacin, fibrate, or hormone replacement therapy.