Cholesterol screening

Overview

Cholesterol screening is a simple blood test that measures the levels of cholesterol and fats in your blood. It helps find out if you have high cholesterol, which can increase your risk of heart disease and stroke. The screening is done as part of a routine check-up, even if you feel healthy.

Yes, high cholesterol is very common. Many people have it without knowing it, because it often causes no symptoms.

Cholesterol screening is recommended for all adults, but people with a family history of high cholesterol, heart disease, or diabetes may need to start screening earlier or have it more often. Children with certain risk factors may also be screened.

Symptoms

Common symptoms

• High cholesterol itself does not cause any symptoms. Most people feel fine until serious complications, such as a heart attack or stroke, occur.

Symptoms in children

• Children with very high cholesterol usually have no symptoms. Screening may be done if there is a strong family history of high cholesterol or early heart disease.

Symptoms in older adults

• Older adults also typically have no symptoms from high cholesterol. However, the risk of heart disease and stroke increases with age, so screening remains important.

Causes

Main causes

• An unhealthy diet high in saturated and trans fats
• Lack of physical activity
• Being overweight or obese
• Genetics – some people inherit a condition that causes very high cholesterol

Risk factors

• Family history of high cholesterol or early heart disease
• Smoking or exposure to tobacco smoke
• Diabetes or prediabetes
• High blood pressure
• Age (risk increases with age)
• Sex (men tend to have higher risk at a younger age)

When to see a doctor

See a doctor urgently if:

• If you have chest pain, shortness of breath, or any symptoms of a heart attack or stroke, call your local emergency number immediately.

Book a routine appointment if:

• Talk to your doctor about getting a cholesterol screening if you are age 20 or older, even if you feel healthy.
• If you have a family history of high cholesterol or heart disease, ask your doctor if you should be screened earlier or more often.

Diagnosis

Cholesterol is diagnosed through a blood test called a lipid panel or lipid profile. The test measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides. You may be asked to fast (not eat or drink anything except water) for 9 to 12 hours before the test, but some tests do not require fasting. Your doctor will interpret the results based on your overall health and risk factors.

Tests that may be done

• Lipid panel (lipid profile) – measures total cholesterol, LDL, HDL, and triglycerides

What to expect at your appointment

A healthcare professional will draw a small sample of blood from your arm. The process takes only a few minutes. You might feel a quick prick. The blood sample is sent to a lab, and your results are usually available within a few days. Your doctor will discuss what the numbers mean and whether you need to make any changes.

Treatment

Treatment for high cholesterol focuses on lowering your risk of heart disease and stroke. This is usually done through lifestyle changes first. If those are not enough, medication may be recommended. Treatment is tailored to your individual risk, age, and other health conditions.

Self-care at home

• Eat a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Limit saturated fats (found in red meat, butter, cheese) and avoid trans fats (found in some fried and processed foods).
• Get at least 150 minutes of moderate-intensity exercise each week, such as brisk walking, swimming, or cycling.
• Maintain a healthy weight. Losing even a small amount of weight can help lower cholesterol.
• Quit smoking if you smoke, and avoid secondhand smoke.
• Limit alcohol intake. If you drink, do so in moderation.

Medical treatments

If lifestyle changes alone are not enough to lower your cholesterol to a healthy level, your doctor may prescribe medication. Several types of cholesterol-lowering drugs are available, including statins and other medicines that help reduce LDL cholesterol. These medications are taken long-term and are usually safe, but they can have side effects. Your doctor will choose the best option for you based on your cholesterol levels and overall health.

When is surgery considered?

Surgery is rarely needed for high cholesterol. In extreme cases, such as a genetic condition called familial hypercholesterolemia that does not respond to medication, a procedure called apheresis (filtering cholesterol from the blood) may be considered. This is done in specialized centers.

Living with this condition

If you have high cholesterol, it’s important to keep it under control for the long term. This means sticking with healthy habits, taking any prescribed medications, and seeing your doctor for regular check-ups and repeat cholesterol tests. Many people manage high cholesterol successfully and reduce their risk of heart disease.

Lifestyle tips

• Follow a heart-healthy diet low in saturated and trans fats.
• Stay physically active most days of the week.
• Manage stress through relaxation techniques or activities you enjoy.
• Avoid smoking and limit alcohol.
• Take all medications exactly as prescribed, and do not stop without talking to your doctor.

Diet and exercise

A heart-healthy diet includes plenty of fruits, vegetables, whole grains, beans, nuts, fish, and lean meats. Choose healthy fats like olive oil and avocado. Limit processed foods and sugary drinks. Exercise should be a mix of aerobic activities (like walking, cycling, or swimming) and strength training. Even small changes can make a big difference.

Mental health and emotional wellbeing

Finding out you have high cholesterol can cause worry or anxiety about your health. It’s normal to feel concerned. Talking to your doctor, learning about your condition, and taking steps to improve your health can help reduce anxiety. If you feel overwhelmed, consider speaking with a counselor or joining a support group.

Prevention

You can often prevent or delay high cholesterol by living a healthy lifestyle. Eating a balanced diet, staying active, maintaining a healthy weight, and not smoking are the most important steps. Even if you have a family history, these habits can still make a difference. Regular cholesterol screening helps catch problems early so you can take action.

Screening programmes

Cholesterol screening is the key preventive test. Adults should have their cholesterol checked every 4 to 6 years starting at age 20. If you have risk factors, your doctor may recommend screening more often. Children with a family history may also be screened. Talk to your doctor about when you should be tested.

Complications

If left untreated

• High cholesterol can lead to the buildup of plaque in your arteries (atherosclerosis), which narrows and hardens the arteries.
• This increases your risk of a heart attack, angina (chest pain from reduced blood flow to the heart), stroke, and peripheral artery disease (narrowing of arteries in the legs).

Long-term outlook

The outlook for people with high cholesterol is very good – it is a highly manageable condition. With early detection through screening and proper treatment, you can significantly lower your risk of heart disease and stroke. Many people live long, healthy lives by making simple lifestyle changes and, if needed, taking medication as prescribed.

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