When Should I Start Having My Cholesterol Checked? (Hint: Probably Sooner Than You Think)

Regular screening is vital to understanding your heart risk
Illustration of blood sample for cholesterol check

If you’re a healthy 20- or 30-something, you’re probably more concerned about work stress and finances than about your cholesterol. But it’s important to know your numbers — and it’s not something you should delay thinking about until middle age.

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Why? Because studies show that high cholesterol can have long-term effects on your heart health. And because it doesn’t have obvious symptoms, you could have it without knowing.

Why cholesterol screening is so important

Your body needs some cholesterol (a waxy, fat-like substance in your blood) to perform certain functions. But when there’s too much of it circulating in your blood, it can start to build up on the inside walls of your blood vessels, which restricts the flow of blood to your heart and brain. Eventually, this could cause a heart attack or stroke.

Statin therapy and certain lifestyle changes are effective ways to bring high cholesterol down to a healthy range. But most people won’t know that they have high cholesterol just by the way they feel.

That’s where screening comes in. “A lipid panel is an easy, inexpensive screening blood test that can be very helpful in identifying patients that are at risk for cardiovascular disease,” explains preventive cardiologist Luke Laffin, MD.

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What is a lipid panel blood test?

A recent Cleveland Clinic survey found that only one in five Americans are aware that lipid panel cholesterol testing should begin in a person’s 20s, even if they don’t have symptoms of heart disease.

The latest guidelines from the American College of Cardiology and the American Heart Association call for healthy adults who do not have heart disease to have their cholesterol levels tested every four to six years, starting at age 20.

People who have heart disease or who are taking cholesterol-lowering medications, or those who have additional risk factors, may need to have it tested more often. Certain children who are at high risk for heart disease should also be screened.

Your primary care doctor can order this test. While there are cholesterol home test kits that can be purchased at drug stores or online, Dr. Laffin recommends against using them. “There’s too much variability in measurements from brand to brand,” he says. “I would recommend having this done by a professional laboratory.”

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A lipid panel will measure some or all of the following:

  • Total cholesterol. Optimal total cholesterol level is < 200 mg/dL.
  • Low-density lipoprotein (LDL) cholesterol, also called “bad” cholesterol. The optimal LDL level is < 100 mg/dL.
  • High-density lipoprotein, also called “good” cholesterol. The optimal HDL level is > 60 mg/dL.
  • Triglycerides, which are another kind of fat molecule. The optimal level of triglycerides is < 150 mg/dL.

If your numbers do not fall into a healthy range, your doctor may prescribe a statin or recommend making some changes to your diet or lifestyle.

Cholesterol management is key in minimizing your risk for heart disease and stroke — but it’s important to remember that it is only one factor that contributes to your risk. Your doctor can work with you to determine your risk based on your cholesterol numbers plus other risk factors like family history, cigarette smoking, blood pressure and age.

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