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Cholesterol: Screening or Testing, Teen Version

What is cholesterol?

Cholesterol is a type of fat in the blood. It is needed for building hormones and cells. Everyone needs to have some cholesterol in their blood. Having too much cholesterol, however, is a problem.

What you eat affects the level of cholesterol in your blood. Cholesterol comes from animal products such as meat, eggs, and dairy products. If you eat less cholesterol and saturated fat, you will have less cholesterol in your blood.

Cholesterol has several parts: high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides. HDL is called "good" cholesterol because it carries cholesterol away from the arteries to the liver. The liver helps the body get rid of cholesterol. The LDL is called "bad" cholesterol. If you have too much LDL, cholesterol builds up in the arteries. As a result your arteries become clogged. The HDL, LDL, and triglycerides together are called "total cholesterol."

Why is having low cholesterol important?

Teens who have higher-than-normal levels of cholesterol have a higher risk of eventually developing clogged or narrowed blood vessels that carry blood to the heart muscle. Lower cholesterol levels can reduce the risk of heart disease or a heart attack.

Reducing cholesterol levels with healthy food choices and physical activity gives teens a better chance of having low cholesterol when they are adults.

What are normal and abnormal cholesterol levels?

Normal levels of total cholesterol in teens are between 110 and 170 mg/dl. After age 18, the levels considered to be normal rise about 1 point per year of age. Levels between 170 and 199 mg/dl are considered to be borderline high. Levels higher than 199 mg/dl in teens are high.

Levels of HDL, or "good" cholesterol, should be over 45 mg/dl in teens. A borderline value is between 40 and 45 mg/dl. A low or abnormal value is less than 40 mg/dl in teens.

Levels of LDL, or “bad” cholesterol, should be less than 110 mg/dl in teens. A borderline value is 110 to 129 mg/dl. A high or abnormal value is more than 130.

Should I have my cholesterol level checked?

The American Academy of Pediatrics and the National Heart, Lung, and Blood Institute (NHLBI) recommend that all children between ages 9 and 11 have cholesterol tests. Another cholesterol test should be done between ages 17 and 21.

How often do I need my cholesterol level checked?

If the test results show the cholesterol level is normal, but you are at high risk, your cholesterol should be checked every 3 to 5 years. You’re at high risk if you:

  • Are overweight or have obesity
  • Have high blood pressure
  • Smoke cigarettes
  • Have diabetes
  • Have a father or grandfather who had heart disease before the age of 55, or a mother or grandmother who had heart disease before the age of 65
  • Have a relative with high cholesterol or a lipid disorder

If your total cholesterol level is borderline high, between 160 and 190, you will start a program that includes a healthy food choices and physical activity. Your total cholesterol will probably be rechecked every year.

Teens with total cholesterol greater than 190 will have a lipid panel test. This test measures the levels of LDL, HDL, and triglycerides, as well as total cholesterol. These levels will be checked again after 2 to 4 months of treatment. Usually the test is done the first thing in the morning, before you eat or drink anything except water. You must be fasting for the test to be accurate.

You may need to take medicine to lower cholesterol if:

  • One or two tests show you have high levels of cholesterol
  • You are at high risk for heart disease
  • Diet and exercise do not lower cholesterol enough

Talk with your healthcare provider about what is best for you.

Should my whole family be checked?

If you have high cholesterol, everyone in your family should have their total cholesterol checked. Very often the close relatives of teenagers with high cholesterol also have high cholesterol. It is often helpful to start the whole family on a healthier diet and exercise program.

Written by Robert M. Brayden, MD, Professor of Clinical Pediatrics, University of Colorado School of Medicine.
Pediatric Advisor 2019.4 published by Change Healthcare.
Last modified: 2019-04-09
Last reviewed: 2018-05-09
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2018 Change Healthcare LLC and/or one of its subsidiaries
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