Types of Cholesterol Tests

The connection between cholesterol and heart disease has been firmly established in medical literature and public awareness, but the medical view is considerably more nuanced. The American Heart Association recommends following the advice of a 2003 expert panel of the National Cholesterol Education Program, that recommends everyone older than 20 get a full fasting lipoprotein profile --- including total cholesterol; low-density lipoproteins, or LDL ("bad" cholesterol); high-density lipoproteins, or HDL ("good" cholesterol); and triglycerides --- at least every five years.

Full Fasting Lipoprotein Profile

• A full fasting lipoprotein profile is obtained through laboratory tests of a sample of blood drawn from a vein when you haven't had anything to eat or drink in at least nine hours, and it requires a doctor's informed interpretation. It measures total cholesterol; low-density lipoproteins, or LDL ("bad" cholesterol); high-density lipoproteins, or HDL ("good" cholesterol); and triglycerides.

  Total cholesterol is the simplest cholesterol value and provides no more than a general guideline. The longstanding desirable level is less than 200 milligrams per deciliter (mg/dL) of blood.

  LDL is the bad cholesterol that clogs arteries. The U.S. National Heart, Lung and Blood Institute's expert panel has recommended since before 2003 a target value of less than 130 mg/dL for LDL in your lipid profile, and optimally less than 100 mg/dL.

  HDL is the "good" cholesterol that can help keep LDL from sticking in your arteries. A healthy reading is at least 40 mg/dL, and 60 or higher is even better.

  Triglycerides are made in your liver. A healthy level is considered to be below 150 mg/dL. Very high levels, above 500 mg/dL, can contribute to inflammation of the pancreas.

Public Screening

• Communities and community groups may offer low-cost screening cholesterol tests, especially during national cholesterol month, September, but these events rarely offer complete fasting lipoprotein profiles. Their reports of total cholesterol and perhaps HDL may be useful prompts to get individuals at high risk to their doctors for more detailed analysis. The American Heart Association particularly promotes screening of groups most likely to have unrecognized risk levels, such as young men. They promote "Heart at Work" screenings and support events for communities that may be underserved by preventive medical care, such as those with low income and education levels.

Home Cholesterol Tests

• Kits for self-screening cholesterol levels at home, using only drops of blood from a pricked finger, are sold in retail stores and on the Internet. Because these kits rarely provide more than estimates of total cholesterol, they do not require fasting and provide little of the information a doctor will need to prescribe treatment, experts such as Dr. Thomas Behrenbeck, a Mayo Clinic cardiologist, and the writers of the "Harvard Medical School Family Health Guide" find even the lowest-cost home tests not worth the price.