Understanding Lipid Panels

Ahead of a regular visit to your primary care provider, you may be asked to do a lipid panel screening to check for levels linked to your heart health.

Lipids are fatty compounds that live in your blood that tell us if we are at risk of developing heart disease or other heart-related conditions.

A lipid panel helps to determine whether you might be at risk for developing cardiovascular disease. If you already have cardiovascular disease and have had a stroke, heart attack, or other serious heart condition, lipid pane reduces the risk of any future events by treating any abnormalities.

Gaurav Sharma, MD, is a non-invasive cardiologist and board-certified lipidologist with Rochester Regional Health. He explains why lipid panels are important and what they can reveal about our heart health.

What is part of a lipid panel?

A standard lipid panel assesses lipid particles in your bloodstream, including:

• total cholesterol
• low-density lipoprotein (LDL) cholesterol
• high-density lipoprotein (HDL) cholesterol
• triglycerides

There are two main types of cholesterol tracked in lipid panels: LDL cholesterol and HDL cholesterol. Cholesterol helps the body to produce hormones, cell membranes, and assist with other forms of development. However, if there is too much cholesterol in your blood, it can start to stick to artery walls – causing narrowing or even blockages.

LDL cholesterol carries apolipoprotein B, which can lead to plaque buildup along your blood vessels, raising your blood pressure and leading to more strain on your heart.

HDL cholesterol carries apolipoprotein A1, which has anti-inflammatory properties and may help to reduce overall cholesterol formation by helping your body get rid of extra cholesterol.

Triglycerides are a type of fat that help your body with diet and energy storage. When you eat foods with butter, oil, and other fats, your body changes the extra fats into triglycerides and stores them in fat cells called chylomicrons. When your body needs energy, it releases the stored triglycerides.

“There is usually an inverse relationship with high triglycerides and HDL, meaning people that have high triglycerides will tend to have low HDL,” Dr. Sharma said.

How to prepare for lipid panels

A blood draw is needed to determine your lipid levels, which should be done 3-5 days before a scheduled visit with your primary care or other healthcare provider.

Once the lipid panel is ordered, generally you do not need to fast ahead of your blood draw unless your primary care provider or cardiologist specifically requests a fasting blood draw.

After the blood draw is complete, results for the lipid panel are typically available on the same day.

What lipid panels can reveal about heart health

For people ages 20 and older, a normal cholesterol level is between 125 and 200 mg/dL. In this range, the levels should be

• LDL: less than 100 for both men and women
• HDL: 40 or higher for men; 50 or higher for women

Triglycerides should be below 150 mg/DL. Borderline high levels are 151-199; high levels are 200-499. Very high levels are over 500.

“If you are a patient with existing cardiovascular disease, those numbers are more strict,” Dr. Sharma said.

Non-invasive cardiologists will also use cardiovascular health risk calculators to account for additional risk factors such as family history, blood tests, personal history of preeclampsia and determine your personal level of risk for heart disease.

“Depending on whether you fall into a low, intermediate or high-risk category, that will help us decide whether you need certain types of treatment,” Dr. Sharma said.

What influences your lipid levels

“I would say the number one influence on lipid levels is genetics,” Dr. Sharma said. “We all respond differently in terms of our genetic makeup to what we're eating.”

Hereditary factors that influence lipid levels include:

• Diabetes or prediabetes
• Thyroid conditions
• Kidney conditions
• Preeclampsia

Genetic screening services are available for familial hypercholesterolemia.

There are also lifestyle changes you can make to reduce your overall lipid levels. These can include:

• Avoiding foods with lots of saturated or trans fats
• Eating more plants in general
• Getting 30 minutes of moderate aerobic exercise 5 days a week
• Quitting smoking
• Eliminating alcohol use

Regular physical activity is helpful at keeping triglyceride levels low and HDL at a healthy level.

“If you have tried changing your eating and exercise habits but your lipid levels are still higher than they should be, your primary care provider is a great resource when it comes to suggesting any new medications that may help lower your cholesterol,” Dr. Sharma said.