HOW TO CHECK CHOLESTEROL LEVELS
Cholesterol is a sort of fat (lipid) in the blood. While high-density lipoprotein (HDL) or “good” cholesterol helps in the protection of the heart by removingcholesterol from the arterial wall, low – density lipoprotein (LDL) or “bad” cholesterol could clog the arteries in the body.
How is a lipid profile used?
The lipid profile is used to help determine your risk of heart disease and to help guide you and your doctor in deciding what treatment may be best for you if you have borderline or high risk.Epidemiological studies suggest that in middle aged men, higher LDL(each 1mg /dl increase is associated with a 1% increase) and lower HDL (each 1 mg % decrease is associated with a 2% risk increase) are important targets in cardiovascular prevention.
Overall risk factors such as your age, family history, smoking history and high blood pressure must be considered when interpreting your results — ie, your desired cholesterol level depends on your overall risk profile, the higher your your baseline risk ;,the lower the goal. Once you know your numbers, your doctor will recommend a treatment and prevention plan which includes diet and exercise and sometimes medications, as well as follow-up testing to make sure the plan is getting you to your cholesterol goals.
If you’re admitted to the hospital for a major coronary event, your lipid profile is checked the next day morning in the fasting state. However, it may take four to six weeks before your fasting lipid profile stabilizes and you can get accurate results. lipid lowering medications like statins are started in all patients unless there are contraindications.
If you have your cholesterol checked at a medical camp , make sure a reputable company does the screening. Remember that your cholesterol level is just part of your overall cardiovascular risk profile, and your other risk factors must be considered. Lowering cholesterol alone does not reduce your cardiovascular risk and it is not the heart alone that is affected by high levels of cholesterol.The arteris supplying brian and kidneys can get affected in which case the patient may present with a stroke or kidney failure. You should share the screening results with your doctor so that your tests can be properly interpreted, and an appropriate treatment and prevention plan developed.
WHEN SHOULD ONE START CHECKING
Everyone age 20 and older should have a fasting lipid profile.
If you are not fasting when the test is done, your doctor won’t be able to get an accurate lipid profile and may need to test you again Non fasting samples primarily affect triglycerides and VLDL. Be sure to review your test results with your doctor so that you can understand and follow your treatment plan.
Recently experts feel that lipoprotein a also should be measured in individuals with risk factors or those with established heart disease.The level of lipoprotein a should be below 50 mg%.lipoprotien a cannot be reduced with diet of exercise , which explains why some patients with no risk factors and good lifestyle still get heart disease. About 20% of people are thought have lipoprotien a levels above 50 mg%.statins alone will not be enough in these patients ,drugs like nicotinic acid shoud be used in these patients.
How often should I have my cholesterol checked?
All adults age 20 or older should have a fasting lipoprotein profile to be repeated every 5 years
.This test is done after a nine- to 12-hour fast without food, liquids or pills. water can be taken during this period
The lipid profile typically includes:
- Total cholesterol
- High density lipoprotein cholesterol (HDL-C — often called good cholesterol
- Low density lipoprotein cholesterol (LDL-C)—often called bad cholesterol
- Triglycerides
An extended profile may also include:
- Very low density lipoprotein cholesterol (VLDL-C)
- Non-HDL-C
Sometimes the report will include additional calculated values such as the Cholesterol/HDL ratio.The best predictor of risk is non HDL cholesterol which can be calculated by subtracting HDL from total cholesterol.(totel cholesterol-HDL).THE value should be less than 100 mg%. If the triglyceride levels are abovr 400 mg% direct measurement of LDL should be done.Basic screening should also include thyroid function studies ,liver function tests,fasting blood sugar and uric acid levels and creatine kinase levels.Hpertryglyceridemia is a frequently overlooked abnormality Iit is present in approximately 25% of the Indian population and is often associated with other causes such as diabetes obesity renal disease and metabolic syndrome.Restricting intake of suger ,alcohol and wieight reduction are effective non drug methords for reducing triglycerides levels
. You may need to have your cholesterol checked more often than every five years if one or more of these situations applies to you:
- Your total cholesterol is 200 mg/dL or more.
- You are a man over age 45 or a woman over age 50.
- Your HDL (good) cholesterol is less than 40 mg/dL.
- You have other risk factors for heart disease and stroke.
TESTING IN CHILDREN
For children and adolescents at low risk, lipid testing is usually not ordered routinely. However, screening with a lipid profile is recommended for children and youths who are at an increased risk of developing heart disease as adults. Some of the risk factors are similar to those in adults and include a family history of heart disease or health problems such as diabetes, high blood pressure (hypertension, or being overweigh)t. High-risk children should have their first lipid profile between 2 and 10 years old, according to the American Academy of Pediatrics. Children younger than 2 years old are too young to be tested.
A lipid profile may also be ordered at regular intervals to evaluate the success of lipid-lowering lifestyle changes such as diet and exercise or to determine the effectiveness of drug therapy such as statins or fibrates.
WHEN LIPID LEVELS SHOULD NOT BE CHECKED