Lipid Panel with Non-HDL Cholesterol

Non-HDL-C

This blood test checks the levels of cholesterol in your body. A lipid panel will show the levels of your total cholesterol, your LDL (bad) cholesterol, and your HDL (good) cholesterol. In general, the higher your total and LDL cholesterol levels, the higher your risk for coronary heart disease. But some heart attacks happen in people who don't have a high LDL level.

Some researchers believe that measuring your non-HDL cholesterol levels gives a better assessment of the risk for heart disease than measuring only LDL. This is especially true if you have high triglycerides. Your non-HDL cholesterol level is found by subtracting your HDL cholesterol from your total cholesterol.  

You may need this test to see if you have high cholesterol. High cholesterol is one of the things that can tell you how likely you are to get heart disease, so it's important to know your cholesterol numbers. When your LDL cholesterol level is high and HDL cholesterol is low, you may be at risk for a heart attack or stroke.

Here's a breakdown of LDL cholesterol levels and health:

• Less than 70 milligrams per deciliter (mg/dL) – if you're at very high risk for a heart attack or had a heart attack

• Less than 100 mg/dL – normal/optimal

• 100 to 129 mg/dL – near or above the optimal

• 130 to 159 mg/dL – borderline high

• 160 to 189 mg/dL – high

• 190 mg/dL and above – very high

Here's a breakdown of total cholesterol levels and health:

• Less than 200 mg/dL – desirable

• 200 to 240 mg/dL – borderline high

• 240 mg/dL and above – high 

Ideally, HDL cholesterol should be above 40 mg/dL for males and above 50 mg/dL for females. The higher your HDL level, the better.

The test for non-HDL cholesterol isn't usually part of screening for your total cholesterol. But if you have high blood pressure, diabetes, or other risk factors for heart disease, your chances of having a heart attack are higher than normal. In these cases, your healthcare provider may calculate your non-HDL cholesterol, too.

Your provider may also order this test if a blood test shows you have high levels of triglycerides, another type of fat in the blood. A high non-HDL cholesterol level alone isn't a warning sign that something is wrong with your arteries or heart, but if your triglycerides measure more than 200 mg/dL, your provider may prescribe medicine to help lower both your LDL and your non-HDL cholesterol. 

If your healthcare provider suspects you have heart disease, you may also get these tests:

• Electrocardiogram (ECG). This tests your heart's electrical impulses to see if your heart is beating normally.

• Stress test. This test is done while you have an ECG. You may have to walk or run on a treadmill. Or you will a receive a drug that mimics the effects of exercise.

• Echocardiogram. This test uses sound waves (ultrasound) to show how well your heart muscle is working.

• Cardiac catheterization. A thin flexible tube is guided into your blood vessel. Dye is then injected which will show on an X-ray if there are any clogs in the arteries of your heart.

People with a history of artery disease, stroke, kidney disease, or diabetes are also at higher risk for heart disease, so tests may be done to look for these problems, too. 

Test results may vary depending on your age, gender, health history, and other things. Your test results may be different depending on the lab used. They may not mean you have a problem. Ask your healthcare provider what your test results mean for you.

Although no clear standards exist for non-HDL levels, most medical experts believe that lowering LDL and non-HDL cholesterol at the same time may cut your heart disease risk.

According to cholesterol guidelines, your non-HDL cholesterol level goal should be 30 mg/dL higher than your LDL cholesterol level goal. For example, if you are aiming for an LDL cholesterol of 100 mg/dL, then your goal for non-HDL should be 130 mg/dL.

If you have diabetes, smoke, have a family history of heart disease, or have other risk factors, your cholesterol levels may need to be much lower. Talk with your healthcare provider about where your cholesterol levels should be. 

The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand. 

Having a blood test with a needle carries some risks. These include bleeding, infection, bruising, and feeling lightheaded. When the needle pricks your arm or hand, you may feel a slight sting or pain. Afterward, the site may be sore. 

Your cholesterol levels can be affected by:

• What you eat
• How often you exercise
• What medicines you take
• Whether you smoke

A lipid test can be done with or without fasting. You may need to fast if your triglycerides are going to be measured. This means you can have nothing but water for about 9 to 12 hours before the test. Tell your healthcare provider about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illicit drugs you may use.