Cholesterol Testing Guidelines: Questions and Answers

Q1: When should cholesterol testing begin for most adults?

A: For most adults, cholesterol testing should start at age 45. Blood lipids should be checked every five years without other health concerns.

Q2: What tests are included in cholesterol checks?

A: Tests include:

  • Total cholesterol
  • LDL (“bad” cholesterol)
  • HDL (“good” cholesterol)
  • Triglycerides (TGs)

A fasting sample is important if triglycerides need to be assessed.

Q3: How often should cholesterol tests be repeated for low-risk individuals?

A: Low-risk individuals (less than 10% chance of heart disease) should repeat cholesterol tests every five years.

Q4: What about Aboriginal and Torres Strait Islander peoples?

A: Testing for Aboriginal and Torres Strait Islander peoples should begin at age 35. Their cholesterol levels should be checked every five years due to a higher risk of heart disease.

Q5: Who is considered at moderate risk for heart disease?

A: Individuals with a 10–15% chance of heart disease over 5–10 years are considered at moderate risk. This includes people with:

  • Family history of early heart disease
  • Certain ethnic backgrounds (e.g., Aboriginal, South Asian)

Q6: How are moderate-risk patients managed?

A: Moderate-risk patients should:

  • Follow intensive lifestyle changes.
  • Have cholesterol checked every two years.
  • Consider medication if cholesterol targets aren’t met within six months.

Q7: Who is considered high-risk for heart disease?

A: High-risk individuals include those with:

  • A 15% or higher chance of heart disease.
  • Diabetes (especially over age 60 or with kidney problems).
  • Chronic kidney disease.
  • Very high blood pressure.
  • Very high cholesterol.

Q8: How often should high-risk individuals have their cholesterol checked?

A: High-risk individuals should have their cholesterol checked every year.

Q9: What treatments are recommended for high-risk individuals?

A: High-risk patients are advised to:

  • Start cholesterol-lowering medication immediately.
  • Make lifestyle changes to improve overall health.

Q10: What lifestyle changes help lower cholesterol?

A: Key lifestyle recommendations include:

  • Eating a heart-healthy diet low in saturated fats.
  • Exercising at least 30 minutes most days.
  • Maintaining a healthy weight.
  • Avoiding smoking and limiting alcohol intake.

Q11: What are the cholesterol level goals for treatment?

A: Goals include:

  • Total cholesterol <4.0 mmol/L.
  • LDL <2.0 mmol/L.
  • HDL ≥1.0 mmol/L.
  • Triglycerides <2.0 mmol/L.

Q12: Do people with existing heart disease need regular cholesterol checks?

A: Yes, they should have cholesterol tests every year and follow a treatment plan that includes medications and lifestyle changes.

Q13: What happens if cholesterol test results are abnormal?

A: Before making a diagnosis or starting treatment, a second test should be done on a different day to confirm the results.

Q14: Are finger-prick cholesterol tests reliable?

A: These quick tests provide an estimate, but accurate results require confirmation with a full blood test.

Q15: Why is managing cholesterol important?

A: High cholesterol can lead to heart disease and stroke. Regular testing and management help lower these risks and improve long-term health.