Take the Cholesterol Quiz

Depending on your results, your healthcare provider may tell you to have the test more often. People assigned male at birth who are ages 45 to 65 and people assigned female at birth who are ages 55 to 65 should be screened every 1 to 2 years. Your provider may also advise making changes to things you can control (modifiable risk factors) such as eating a healthy diet, losing weight, stopping smoking, and getting more exercise. The best blood test to check cholesterol is a lipoprotein profile. This is done after you fast for 9 to 12 hours. A lipoprotein is a substance in the blood that carries cholesterol and other fats to the body's cells. The most important lipoproteins are:

• Low-density lipoprotein (LDL), known as "bad" cholesterol
• High-density lipoprotein (HDL), known as "good" cholesterol

Cholesterol checks that don't require you to fast aren't as accurate. But they can give you a general idea about your cholesterol levels. They can give you a total cholesterol level and the HDL level. If your total is 200 mg/dL or more, or if your HDL level is less than 40 mg/dL, you will need to get a lipoprotein profile.

Low-density lipoprotein is the main cholesterol carrier in the blood and the main source of cholesterol buildup in the body. The best LDL level is less than 100 mg/dL. Next best is 100 to 129 mg/dL. High LDL level is considered 160 mg/dL and above. Triglycerides are another form of fat in the blood. Like LDL cholesterol, they raise the risk for heart disease and stroke. A high triglyceride level is 200 mg/dL or more. Borderline high is 150 to 199 mg/dL.

Researchers think that high-density lipoprotein carries cholesterol away from the arteries, to the liver. From there it then passes out of your body. The higher HDL number you have, the better. Researchers say that an HDL level of less than 40 mg/dL makes it more likely that you will get heart disease. An HDL level of 60 mg/dL or more helps lower your risk for heart disease.

Saturated fats and cholesterol in your diet make your blood cholesterol go up. You can find out how much cholesterol and fat are in foods by reading the nutrition labels. The main culprit is saturated fat. This fat is found in animal fats such as meats and whole-milk dairy products. Try to limit how much saturated fat you have each day to less than 10% of your total daily calories, based on your health. Cholesterol in your food also matters. Try to limit how much cholesterol you eat each day to no more than 300 mg. Cholesterol is found in egg yolks, meat, poultry, seafood, and whole-milk dairy products. Trans fats are found in commercially baked goods and stick margarine. These fats can also raise blood cholesterol. Try to limit how much of these you eat. If you're overweight, losing weight can help lower your levels of LDL cholesterol and triglycerides. Losing weight can also raise your HDL cholesterol level. Adding soluble fiber to your diet also can help lower LDL levels.

Not being physically active makes it more likely that you will get heart disease. You should try to get at least 30 minutes of moderate physical activity on most — if not all — days. If you haven't been active, check with your healthcer provider before starting any new exercise program.

You can't do anything about your age or family history of heart disease, but you can quit smoking and take steps to control your blood pressure. As people get older, their cholesterol levels rise. LDL levels tend to rise after menopause. High blood cholesterol also can run in families. Other risk factors for heart disease include little or no physical activity and obesity.

Depending on your cholesterol levels and your risk factors for heart disease, you may only need "therapeutic lifestyle changes." This may mean changing your diet, adding or getting more exercise, stopping smoking, or losing weight. If your risk is higher, you will also need to take medicine to lower your cholesterol levels. Medicines for lowering cholesterol include statins, bile acid sequestrants, nicotinic acid, and fibric acids. Your doctor will tell you which medicine is right for you.