Diagnostic Examinations focusing on Cholesterol Levels
A cholesterol test, often referred to as a lipid panel, is a crucial tool in assessing heart health. It measures the levels of cholesterol and other fats in your blood, providing valuable insights into your risk of developing coronary heart disease.
A standard lipid panel includes measurements for total cholesterol, LDL ("bad") cholesterol, HDL ("good") cholesterol, and triglycerides. In some cases, it may also include calculated values like VLDL and LDL particle number [1][3][5].
While a basic cholesterol test may sometimes refer to just total cholesterol or total cholesterol with HDL and LDL, the lipid panel offers a more comprehensive picture of your heart health. Advanced lipid testing, although not included in the standard panel, can provide even more detailed information [2].
The lipid panel is the standard screening method to evaluate cardiovascular risk and monitor patients with risk factors such as age, smoking, obesity, hypertension, diabetes, or family history of heart disease [1]. It is used for both initial screening and ongoing monitoring of cholesterol levels, especially when patients are on cholesterol-lowering treatments or have known lipid abnormalities [1][4].
Advanced lipid testing can assess apolipoproteins, identify subspecies of HDL and LDL, and measure the number of LDL particles. This testing is particularly useful for people at increased risk of cardiovascular disease [4].
A cholesterol ratio, calculated by comparing the levels of good and bad cholesterol, is a strong predictor of coronary heart disease. Ratios like total-cholesterol-to-HDL greater than six and LDL-to-HDL greater than four indicate a high risk for coronary heart disease [1].
Tests that indicate subclinical atherosclerosis, like ankle-brachial blood pressure index (ABI), carotid sonography, and coronary calcium tests, can provide additional information about your coronary heart disease risk. Coronary calcium tests are not routinely recommended but can be useful in people more likely to have coronary heart disease, and their doctor wishes to determine whether more intensive therapy may be beneficial [1].
Biomarkers of cardiovascular disease, such as homocysteine, fibrinogen, C-reactive protein (CRP), B-type natriuretic peptide, D-dimer, and subclinical atherosclerosis tests, can also help doctors determine the level of therapeutic intensity for both high cholesterol and high blood pressure [1].
Non-HDL cholesterol, the total of VLDL and LDL cholesterol, is a better predictor of the risk of coronary heart disease than a simple measure of LDL cholesterol. Non-HDL cholesterol should be lowered to 30 mg/dL greater than the LDL-cholesterol goal when LDL cholesterol is at goal [1].
Measuring certain biomarkers, such as CRP, can help doctors determine the level of therapeutic intensity for both high cholesterol and high blood pressure. Apo B testing, a direct measure of apolipoprotein B, may be useful in people who are at high risk of coronary heart disease [1].
It's important to note that the accuracy of cholesterol tests can be influenced by factors such as age, sex, seasonal variations, recent changes in diet or weight, alcohol intake, exercise, family history, other illnesses, pregnancy, and certain medications [1]. A lipid panel requires 9 to 12 hours of fasting, and only the results for total cholesterol and HDL cholesterol are valid when not fasting [1].
Large-scale cholesterol screening is possible with portable machines that deliver results in less than ten minutes, using blood drawn by pricking a finger. However, these results should be confirmed at a doctor's office or laboratory for greater accuracy [1].
All adults over age 20 should have a lipid panel obtained every five years. People at high risk of coronary heart disease may be recommended to get a lipid panel more frequently [1].
In conclusion, a lipid panel is the comprehensive standard test used to assess and monitor heart disease risk. While a basic cholesterol test may sometimes mean only part of the panel, today it usually refers to this same lipid profile test. The lipid panel is recommended for people with cardiovascular risk factors and for periodic screening in adults. For people at increased risk of cardiovascular disease, the results of advanced lipid testing, biomarkers, or tests for subclinical atherosclerosis might influence treatment decisions.
The lipid panel, a comprehensive test, offers insights into the risk of developing medical-conditions like coronary heart disease, by measuring levels of cholesterol and other fats in the blood. The results of this test can be crucial in health-and-wellness management. In some cases, advanced lipid testing can provide additional details, such as assessing apolipoproteins or measuring LDL particle number, which may influence treatment decisions for individuals at increased risk of cardiovascular disease. Regular screening and monitoring are crucial for maintaining heart health, and all adults over age 20 are recommended to have a lipid panel obtained every five years.
