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Levels of serum cholesterol have been correlated with a person's subsequent risk of heart disease. Clinical studies have shown that serum cholesterol screening may reduce the risk of heart disease. In short, the current recommendation is that everyone get a fasting lipid profile every five years starting at age 20 if the results are in the desirable range. If the results are high, or if you have a family history of coronary artery disease, you should be tested more frequently.
The American College of Physicians, the U.S. Preventive Services Task Force, and the Canadian Task Force on the Periodic Health Examination recommend measuring serum cholesterol every five years, starting in early adulthood.
The U.S. Preventive Services Task Force (USPSTF) recommends periodic total serum cholesterol and high-density lipoprotein cholesterol (HDL-C) screening for all men aged 35 and older and all women aged 45 and older. The USPSTF recommends screening beginning at age 20 for men and women with other risk factors for coronary heart disease, such as: - diabetes
- a family history suggestive of hyperlipidemia
- a family history of cardiovascular disease before age 50 in male relatives or age 60 in female relatives
- patients with multiple coronary heart disease risk factors such as tobacco use or hypertension.
They recommended an interval of 5 years between tests, but longer intervals may be reasonable in low-risk subjects, including those with previously desirable cholesterol levels. For average risk individuals, the benefit of measuring triglycerides as an initial screening is unproven.
The USPSTF recommends screening with total cholesterol, HDL-C, and lipoprotein analysis for persons with major coronary heart disease risk factors (e.g. smoking, hypertension or diabetes). These guidelines recommend, for high-risk persons, lipoprotein analysis to help identify individuals at highest risk of coronary heart disease (CHD) in whom individual diet or drug therapy may be indicated. The optimal frequency of screening has not been determined and is left to clinical discretion.
The American College of Physicians (ACP) - American Society of Internal Medicine, in guidelines revised in 1996, concluded that screening serum cholesterol was appropriate but not mandatory for asymptomatic men aged 35 to 65 and women aged 45 to 65; the guidelines do not recommend screening for younger persons unless they have evidence of having a familial lipoprotein disorder or have multiple cardiac risk factors. The ACP concluded that evidence was not sufficient to recommend for or against screening asymptomatic persons between the ages of 65 and 75, but the ACP recommends against screening after age 75.
In addition, the National Cholesterol Education Program (NCEP) recommends routine measurement of a fasting lipoprotein profile (total cholesterol, LDL cholesterol, high density lipoprotein (HDL) cholesterol, and triglyceride) in all adults age 20 and older at least once every 5 years. The American Academy of Family Physicians recommends measurement of total cholesterol at least every 5 years in adults age 19 and older.
The American College of Obstetricians and Gynecologists recommends periodic screening of cholesterol in all women over age 20.
Cholesterol skin testing is a non-invasive test that entails placement of a few drops of fluid in the fleshy area of the palm near the base of the thumb and measurement of the resulting color change with a special device. The new test, known as Cholesterol 1,2,3(TM) (IMI International Medical Innovations Inc., Toronto, Canada), does not involve fasting or waiting hours or days for results, instead being available in three minutes. Well-designed clinical trials are needed to ascertain the effectiveness of cholesterol skin testing in predicting CHD as compared to standard methods of cholesterol testing (e.g. blood cholesterol tests).
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Cholesterol Level Check can help with the following:
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GLOSSARY
Arterial (Arteries, Artery)
Blood that leaves the heart. When it leaves the right ventricle, it is venous blood; and when it leaves the left ventricle, through the aorta, it is fresh and oxygenated. After it has passed out to the capillaries and started to return, it is venous blood.
Asymptomatic
Not showing symptoms.
Cardiac
Pertaining to the heart, also, pertaining to the stomach area adjacent to the esophagus.
Cardiovascular
Pertaining to the heart and blood vessels.
Cholesterol
A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.
Diabetes Mellitus (Diabetes, Diabetic, Diabetics)
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
High-Density Lipoprotein (HDL)
Also known as "good" cholesterol, HDLs are large, dense, protein-fat particles that circulate in the blood picking up already used and unused cholesterol and taking them back to the liver as part of a recycling process. Higher levels of HDLs are associated with a lower risk of cardiovascular disease because the cholesterol is cleared more readily from the blood.
Hyperlipidemia
Increased cholesterol level: Elevated blood fats, either from heredity, from having so many calories in the diet that they are ending up as liver-synthesized storage fats, from an excessively anabolic metabolism. Also from a constellation of less
common disease causes.
Hypertension
High blood pressure. Hypertension increases the risk of heart attack, stroke, and kidney failure because it adds to the workload of the heart, causing it to enlarge and, over time, to weaken; in addition, it may damage the walls of the arteries.
Lipid (Lipids)
Fat-soluble substances derived from animal or vegetable cells by nonpolar solvents (e.g. ether); the term can include the following types of materials: fatty acids, glycerides, phospholipids, alcohols and waxes.
Lipoproteins (Lipoprotein)
Molecules composed of lipids and proteins that carry fats and cholesterol through the bloodstream.
Low-Density Lipoprotein (LDL)
Also known as "bad" cholesterol, LDLs are large, dense, protein-fat particles composed of a moderate proportion of protein and a high proportion of cholesterol. Higher levels of LDLs are associated with a greater risk of cardiovascular disease.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Triglyceride (Triglycerides)
The main form of fat found in foods and the human body. Containing three fatty acids and one unit of glycerol, triglycerides are stored in adipose cells in the body, which, when broken down, release fatty acids into the blood. Triglycerides are fat storage molecules and are the major lipid component of the diet.
Last updated: Apr 13, 2008
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