Better understand your blood cholesterol status

The cholesterol test, or lipid test, is carried out in order to measure all the lipid parameters. It is a blood test that accurately analyzes all the “fractions” of cholesterol and helps to distinguish the “good” from the “bad” cholesterol. How to decode the results? Are there any contraindications?

The cholesterol test is a precise blood test , carried out following the discovery of an increase in the total cholesterol level, to monitor the appearance of a cholesterol anomaly or to control an already known anomaly. Depending on the results, it is advisable to implement hygienic and dietetic measures (diet, physical activity …) or drug treatments.

What is a lipid check-up?

The examination consists of taking a tiny amount of blood from a vein, which is then collected in tubes to be analyzed by a laboratory. The following will be measured: total cholesterol, LDL-cholesterol (“bad” cholesterol), HDL-cholesterol (“good” cholesterol), sometimes apolipoproteins A1 and B, lipoprotein a (Lp(a)), and often triglycerides (other lipids).

What recommendations should I follow before a cholesterol test?

The person must be fasting for at least 12 hours, and the last meal must not have been too fatty (except for raclette…). It is also recommended not to change one’s eating habits in the weeks preceding the test, to avoid alcohol consumption, smoking or very intense physical activity during the 72 hours preceding the test

How is the sample taken?

The examination is most often carried out in a medical laboratory, but it can also take place at home or in hospital. It can be done by a doctor, a nurse, or a medical laboratory assistant. The skin is disinfected locally, at the fold of the elbow, and then the person inserts a single-use needle into a vein in the arm. This usually takes a few seconds. On the check-up, the results are given in g/l and millimoles per liter (mmol/l).

Is the lipid test painful?

As with any blood test, the pain is very slight and of short duration (the time it takes to insert the needle). It can be a little more severe if the person taking the blood has difficulty “finding” the vein and has to move the needle in the collection area.

Are there risks and contraindications?

The risks and contraindications are the same as for a blood test: there are minimal risks of discomfort, hematoma, transmission of diseases through the blood… Generally, no contraindication is definitive.

How long before obtaining the results?

Results can be obtained within a day. They will be sent to the sampled person and to the prescribing physician. The interpretation must be done in a global way, according to the proven pathologies and other risk factors (diabetes, high blood pressure, etc.).

What do the lipid test measurements indicate?

Total cholesterol

This is the amount of cholesterol measured in the blood. It is made by our body from food intake and transported by lipoproteins, including HDL and LDL. Its level varies slightly with age and gender. On average, in adults, it should not exceed two grams per liter (the two numbers separated by a comma indicate age). That is to say 2.40g/l at 40 years old; 2.60 g/l at 60 years old, etc.

HDL cholesterol

It transports cholesterol to the liver where it is recycled, it is the “good cholesterol”. It must be higher than 0.40 g/l for men and 0.50 g/l for women.

LDL cholesterol

It delivers cholesterol to the organs but sometimes these particles are responsible for deposits in the arterial walls, participating in atherosclerosis. It is therefore called “bad cholesterol”. It is not measured, but calculated according to the two previous measurements, according to the following equation: LDL-cholesterol = total cholesterol – HDL-cholesterol – (tryglycerides/5), in g/l. It must be less than 1.60 g/l in men and 1.50 g/l in women.

For this reason, the dosage of triglycerides – made from fats in the diet – is always associated with that of cholesterol. If this value is too high (higher than 3.5 or 4 g/l depending on the laboratory), the calculation of LDL cholesterol is no longer possible. A specific dosage can then be carried out.

The level of cardiovascular risk

Also called “cardiovascular risk score”, it is calculated according to several parameters: gender, total cholesterol, smoking status, blood pressure, for an age between 40 and 65 years old. If your risk is high or very high, the doctor will prescribe statins within 3 months. He or she will encourage you to eat better and be more physically active.

The LDL goal to reach

This is the ideal LDL-cholesterol value to achieve by making lifestyle changes or taking medication. The higher the risk, the lower the value. It is given as an indication and must be analyzed according to the patient’s state of health,” insists Professor Renard. It’s more important to lower the overall risk than the LDL-cholesterol level. »

Why can some values appear in bold?

This indicates an anomaly with respect to the reference standards. “But these should be put into perspective, because the limit values for bad cholesterol vary greatly from one laboratory to another,” warns cardiologist Dr. Yann Pucheu. Above all, they must be analyzed in a global context.

  • If total cholesterol is too high because of high HDL, and LDL is within the norm: “There’s no need to worry, discuss it with your doctor instead,” reassures Prof. Vincent Renard, president of the Collège national des généralistes enseignants. Indeed, a high level of HDL is considered a protective factor.
  • If total cholesterol is too high because of excess LDL, it must be interpreted in relation to other cardiovascular risk factors such as: age, smoking, hypertension, diabetes, gender, weight, kidney failure, family cardiovascular history.

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