Stephen J. Schueler, M.D.

High Serum Cholesterol Evaluation

The evaluation of high cholesterol begins with a medical history and physical examination.

Physical findings in someone with high cholesterol may include:

Tests that may be used to evaluate high cholesterol include:

High Serum Cholesterol Serum Cholesterol

An ideal total cholesterol level is less than 150 mg/dl. High cholesterol levels increase the risk for heart disease.

Relative Heart RiskTotal Cholesterol (mg/dL)
Very Low Risk150
Low Risk200
Average Risk225
Moderate Risk260
High Riskgreater than 300

High Serum Cholesterol Serum HDL

High levels of HDL cholesterol seems to provide protection from damage to the arteries. An HDL over 35 mg/dL lowers the risk of heart disease. However, an HDL less than 35 mg/dL increases risk for heart disease.

Cardiovascular Risk by HDL Levels

Very Low Risk6575
Low Risk5565
Average Risk4555
Moderate Risk2540
High Riskunder 25under 40

Cardiovascular Risk by Total Cholesterol to HDL Ratio
Very Low Risk3.43.3
Low Risk4.03.8
Average Risk 5.04.5
Moderate Risk9.57.0
High Riskover 23over 11

High Serum Cholesterol Serum LDL

High LDL cholesterol increases the risk of damage to the arteries that leads to heart disease. An ideal LDL level is less than 130 mg/dl. A mildly elevated LDL is between 130 and 159 mg/dL. A high LDL is over 160 mg/dL.

Relative Heart RiskLDL Level (mg/dL)Comments
Low Risk< 100Desirable
Average Risk 100 to 129Near optimal / Above optimal
Moderate Risk130 to 159Borderline High
High Risk160 to 189High
Very High Risk190+Very high

Continue to High Serum Cholesterol Treatment

Last Updated: Dec 15, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed High Serum Cholesterol References
  1. Borghi C, Veronesi M, Bacchelli S, Esposti DD, Cosentino E, Ambrosioni E. Serum cholesterol levels, blood pressure response to stress and incidence of stable hypertension in young subjects with high normal blood pressure. J Hypertens. 2004 Feb;22(2):265-72. [15076183]
  2. Morgan JM, Capuzzi DM. Hypercholesterolemia. The NCEP Adult Treatment Panel III Guidelines. Geriatrics. 2003 Aug;58(8):33-8. [12938250]
  3. Schatz IJ, Masaki K, Yano K, Chen R, Rodriguez BL, Curb JD. Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study. Lancet. 2001 Aug 4;358(9279):351-5. [11502313]
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