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Cholesterol is a type of fat in the blood that is needed for building hormones and cells. Everyone needs to have some cholesterol in their blood.
The amount of cholesterol and saturated fats we eat affect the level of cholesterol in our blood. If we eat less cholesterol and saturated fat, we will have less cholesterol in our blood.
Cholesterol has several parts: high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides. HDL is called the "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, the LDL deposits cholesterol on the inner walls of the arteries. As a result your arteries become clogged. The HDL, LDL, and triglycerides together are called "total cholesterol."
People who have higher-than-normal levels of cholesterol have a higher risk of developing clogging or narrowing of the blood vessels that carry blood to the heart muscle. This narrowing is called coronary heart disease (CHD). If people lower their cholesterol levels, they reduce their chances of having heart disease. A 1% decrease in blood cholesterol leads to a 2% decrease in the risk of CHD in adults.
Many children and teenagers who have high cholesterol continue to have high cholesterol when they are adults. Reducing their cholesterol levels with proper diet and exercise gives teens a better chance of having low cholesterol when they are adults.
Normal levels of total cholesterol in teens are between 120 and 170 mg/dl. After age 18, the levels considered to be normal rise about 1 point per year of age. Levels between 171 and 200 mg/dl are considered to be borderline high. Levels higher than 200 mg/dl in teens are high and abnormal.
Levels of HDL, or "good" cholesterol, should be over 45 mg/dl in teens. A borderline low value is between 44 and 35 mg/dl. A low or abnormal value is less than 35 mg/dl in teens.
The American Academy of Pediatrics and the American Heart Association agree that all children and teenagers who are at high risk for coronary heart disease should be screened.
A person is at high risk of developing heart disease as an adult if parents, siblings, grandparents, aunts, or uncles have high blood cholesterol or early heart disease. Early heart disease includes heart attack, angina (chest pain), stroke, or bypass surgery in men less than 50 years old or women less than 60 years old. The information about grandparents is important because other relatives might not yet be old enough to have developed heart disease.
If your cholesterol level is normal, most health care providers check the total cholesterol level every 5 years.
If your cholesterol is borderline high or high, it will be checked again 1 to 2 weeks after the first test. Cholesterol levels do vary somewhat day to day, so it is important to confirm that the cholesterol is high.
Teenagers with confirmed high total cholesterol (greater than the 95th percentile) will then have blood drawn for a lipid profile or panel. This test measures the levels of LDL, HDL, and triglycerides, as well as total cholesterol. Diet and exercise treatment will start and the level of cholesterol will be checked again in about 2 to 4 months.
If your total cholesterol level is borderline high (between the 75th and 95th percentiles), diet and exercise treatment can start without the lipid panel. Your total cholesterol will probably be rechecked every year.
Lipid panels are not done for all people because they cost much more than the total cholesterol test.
If you have a high cholesterol (higher than 95th percentile), we recommend that everyone in your family have their total cholesterol checked. Very often the close relatives of teenagers with high cholesterol also have high cholesterol. Discovering that other family members have high cholesterol will encourage your entire family to start a healthier diet and exercise program.
