Getting a cholesterol test

We recommend that all adults should get a cholesterol check – no matter what your age or how healthy you feel.

Your cholesterol levels depend on your genes as well as your lifestyle, so the only way to know your cholesterol numbers is to get a check.

A cholesterol check involves a simple blood test. When you get a check, your doctor should also check your levels of triglycerides – another type of blood fat.

A cholesterol test can be used along with some other simple tests to give a good idea of your heart health. These include a blood pressure test and finding out your BMI and your waist measurement.

What does a cholesterol check involve?

You can have your cholesterol tested using a simple blood test. This is often a finger prick test, it’s quick, you only feel a small pinch, and the results can be checked there and then. Or, you might have a small blood sample taken from your arm using a needle and syringe, which will be sent off for testing.

You can eat and drink normally before the test unless your doctor asks you not to. If you have a sample taken with a needle and syringe, you might be asked not to eat for 10-12 hours beforehand, usually overnight.

The test should include the amounts of the different types of cholesterol and triglycerides.

If you are worried about your cholesterol, you can email our Cholesterol Helpline ask@heartuk.org.uk

What do the results of a cholesterol test mean?

When you have a cholesterol test, it is really important that your healthcare professional explains the results to you, to prevent unnecessary worry and confusion about the results.

Ask for a print out of your results if you are not able to speak to your GP, nurse or pharmacist.

Total cholesterol

This is sometimes written as TC and refers to the overall level of cholesterol. But it’s not just the total cholesterol that’s important.

Non-HDL cholesterol

Your non-HDL cholesterol is your total cholesterol minus your HDL cholesterol. It’s the LDL and all the other bad cholesterol added together and ideally should be as low as possible.

HDL cholesterol

Your HDL particle (high density lipoprotein) helps clear the cholesterol out of your arteries, while your LDL cholesterol (low density lipoprotein) can clog them up. So your HDL cholesterol should be above 1mmol/L in men and above 1.2mmol/L in women, ideally around 1.5-1.6mmol/L.

TC:HDL ratio

You might be given a ratio of HDL compared to the total cholesterol, written as TC:HDL ratio. You can work it out from your HDL and total cholesterol numbers. This should be as low as possible, and above six is considered high.

The interpretation of your cholesterol results should be made in relation to any other risk factors you may have, and any other health conditions. Because of other risk factors or medical conditions that you may have, your doctor may recommend lowering your cholesterol level.

What is a healthy cholesterol level?

Cholesterol ratio

Sometimes you might be given your total cholesterol only. If this happens, ask for a break-down of the numbers. It’s possible to have a healthy total cholesterol level but an unhealthy ratio of total cholesterol to HDL.

As a minimum, you should be given the total cholesterol (TC) and HDL numbers, then you can work out your cholesterol ratio.

These figures in this cholesterol levels chart are a general guide for ideal cholesterol and triglyceride levels for healthy adults in the UK, they are in millimoles per litre (mmol/L):

Total cholesterol (TC)	below 5mmol/L
Non-HDL cholesterol	below 4mmol/L
LDL cholesterol	below 3mmol/L
HDL cholesterol	above 1mmol/L for a man or above 1.2mmol/L for a woman
Cholesterol ratio TC:HDL ratio	A ratio above 6 is considered high risk - the lower this figure is the better

Triglycerides

Triglycerides are another type of blood fat and your triglyceride levels can tell you more about your health. If your triglycerides are high, it can mean you’re at risk of heart disease, liver disease and diabetes.

You might have your triglycerides tested when you have your cholesterol tested. People with high triglyceride levels often have a low HDL level, which is an unhealthy combination.

As a general rule, these are the ideal triglyceride levels for healthy adults:

Fasting triglyceride	below 1.7mmol/L
Non-fasting triglyceride	below 2.3mmol/L

Where can I get a test?

There are three main ways you can get a test.

Visit your pharmacist.
Visit your GP.
Get an NHS Health Check.

Can I test my own cholesterol at home?

It’s better to have your cholesterol tested by a professional than to use a home cholesterol test. Taking blood and measuring cholesterol levels is a skilled job, and your results will be affected by the way you do the test. Going to a health professional means you will get an accurate reading.

When should you have a cholesterol check?

We believe all adults should know their cholesterol numbers, no matter what your age. Even if you haven’t been invited for a cholesterol check, it’s a good idea to get one anyway, as it’s the only way to know your cholesterol numbers.

You should also be offered a free cholesterol test by the NHS if any of the following apply to you.

You are aged 40-74
Your GP should invite you for an NHS health check once every five years from the age of 40 to 74. The NHS health check is designed to spot the early signs of heart disease, stroke, kidney disease, diabetes and dementia. You’ll be weighed and measured, have a cholesterol check and a blood pressure check, and you’ll be asked some simple questions about your health.
You are at high risk of heart disease
Your GP or practice nurse might also offer you a cholesterol test if you are more likely to develop heart disease. For example, if other people in your family have had it, you smoke, you’re overweight, or you have high blood pressure, diabetes or certain other health problems.

You have been diagnosed with heart disease
Or other related illnesses such as stroke, mini stroke (TIA) or peripheral arterial disease (PAD).
You are taking medicines to lower your cholesterol.
You should be offered a test every year.
You have a close relative with familial hypercholesterolemia.
If your mother, father, brother, sister or child has inherited high cholesterol, you should be offered a test when you find out. This type of high cholesterol runs in families.

Children of parents with familial hypercholesterolemia should be given a cholesterol check by the age of 10.

When should you not have a cholesterol test?

As measurements taken during pregnancy cannot give an accurate picture of a woman’s usual cholesterol levels, cholesterol measurements are not helpful during pregnancy. Find out why.

Heart Age Test

Once you have your cholesterol results you can work out your risk of developing heart disease over the next 10 years using the NHS Heart Age Tool. You can get a more accurate measurement if you know what your blood pressure is and it will tell you your heart age compared to your real age.

The NHS wants to prioritise health checks in those aged between 40-74 but this does not mean other age groups are excluded. People from the age of 25 up to age 84 can still use the heart age tool to work out their risk of heart disease.

What happens if you have high cholesterol?

If you have high cholesterol or triglycerides, or an unhealthy balance of blood fats, you and your doctor will probably want to bring these levels down to a healthy level.

If you have heart disease, or you’re at a higher risk of developing it, your target levels might be lower than the usual healthy levels.

If this is the first time you have had a test which shows you have high cholesterol, your GP should check to make sure that your thyroid gland is working normally, and for any other health problems which could be causing your high cholesterol. Treating the cause could mean your cholesterol is brought under control.

If you have high cholesterol, you may be referred to a lipid clinic to see a doctor who is an expert in treating people with raised blood fats. There are also ways to lower cholesterol naturally yourself by eating healthy and keeping active. You can read more about managing high cholesterol in out healthy living section.

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