Measuring Cholesterol and Triglyceride Levels

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Blood levels of cholesterol and triglycerides have been strongly correlated with a person’s risk of developing coronary artery disease (CAD) and other types of cardiovascular disease. Experts now recommend that blood testing for lipid levels sould be done in everyone.

In some cases, treating abnormal lipid levels (generally with statins) has been shown to reduce cardiovascular risk.

But perhaps more importantly, knowing your lipid levels is a major component of estimating your overall cardiovascular risk - and thus, of understanding how aggressive you should be in reducing that overall risk with lifestyle changes.

Who Should Get a Triglyceride and Cholesterol Test, and When?

Current guidelines recommend that everyone should be tested for cholesterol and triglyceride levels beginning at age 20, and every five years thereafter.

If you are found to have elevated cholesterol or triglyceride levels, you should be tested yearly. In some cases, younger people - and even children - ought to be tested.

How Is the Triglyceride and Cholesterol Test Done?

The test for cholesterol and triglycerides consists of a simple blood test, which today can be done even with the small amount of blood obtained by a needle prick.

The only preparation required on your part is to refrain from eating anything, and from drinking any liquids aside from water, for eight to 12 hours prior to the test. If you are on prescription medication, talk to your doctor about whether you should take your pills before the test.

What Does The Blood Test Measure?

Typically, the lipid panel gives four values:

The actual blood test directly measures total and HDL cholesterol, as well as triglycerides. From these values, an estimate of LDL cholesterol is calculated.

What Are "Desirable" Cholesterol and Triglyceride Levels?

Total cholesterol: Desirable blood levels for total cholesterol are below 200 mg/dL. Levels between 200 and 239 are considered "borderline." Levels above 240 are considered "high."

LDL cholesterol: Optimal LDL levels are less than 100 mg/dL. Near optimal levels are between 100 and 129. Levels between 130 and 159 are considered "borderline;" levels between 160 and 189 are considered "high;" and levels of 190 and above are considered "very high."

HDL cholesterol: In general, the higher the HDL cholesterol levels the better. HDL levels below 41 mg/dL are considered too low.

Triglycerides: Desirable blood levels for triglycerides are less than 150 mg/Dl. Levels between 150 and 199 are considered "borderline high." Levels between 200 and 499 are considered "high." Triglyceride levels at 500 mg/Dl or greater are considered "very high."

Other Lipid-Related Blood Tests

The Apo-B test: The Apo-B test is a measure of the size of the LDL cholesterol particles. Small, dense LDL are associated with a high risk of vascular disease, while larger LDL particles are thought to be less dangerous. However, in most cases a reasonable assessment of a person’s cardiac risk can be made with routine lipid testing alone.

The lipoprotein(a) test: Lipoprotein(a), or LP(a), is a modified form of the LDL lipoprotein that is associated with a higher risk of heart disease than “normal” LDL. Lp(a) levels are thought to be genetically determined, and they cannot be reduced by any known therapy. So measuring Lp(a) is not very useful clinically, and is not done routinely.

When Should You Be Treated For Cholesterol or Triglycerides?

Deciding on whether you ought to be treated for high cholesterol or high triglyceride levels, whether that treatment ought to include drug therapy, and which drugs ought to be used, is not always entirely straightforward. Still, if your cardiovascular risk is elevated, aggressive treatment aimed at your lipid levels can substantially reduce your chances of having a heart attack, or even of dying prematurely. Here is more information on treating cholesterol and triglyceride levels:


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). Circulation 2002; 106:3143.

Greenland P, Alpert JS, Beller GA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2010; 56:e50.

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