All women should have their blood cholesterol checked beginning at age 20. The test should be repeated at least once every five years, more often depending on your risk range. Medicare beneficiaries can now get a free cardiovascular screening test for cholesterol, triglycerides and lipid levels. Ask your health care professional about this benefit.

Additionally, children age two or older with a family history of premature heart disease or at least one parent with high blood cholesterol should have their cholesterol levels tested.

Blood cholesterol levels are measured with a small blood sample. You should have a complete lipoprotein panel, which measures total cholesterol (LDL + HDL), LDL (bad cholesterol), HDL (good cholesterol) and triglyceride levels. Ideally, it should be a fasting panel, completed after you've fasted for nine to 12 hours.

There is a non-invasive cholesterol test available. Called Cholesterol 1,2,3, it consists of placing a few drops of fluid in the fleshy area of the palm near the base of the thumb. The chemicals bind to the cholesterol on your skin and changes color, which is then read by a special handheld reader. You wash the test fluid off with water. The skin test measures only cholesterol on the outer layer of the skin. However, clinical studies find the test, in addition to identifying other risk factors, can accurately assess cardiac heart disease.

Your health care professional may also order "expanded" cholesterol testing, such as the Vertical Auto Profile (VAP) and Berkeley tests. These tests identify the levels of certain types of LDL cholesterol, including the number of particles and their size, providing a more accurate reading of your overall risk of cardiovascular disease.

Additionally, other markers indirectly related to lipids but associated with cardiovascular risk, like homocysteine and C-reactive protein, may be measured.

It is possible to have a standard lipid profile with all your numbers in the target range, but still have an LDL particle number or homocysteine level that increases your risk for cardiovascular disease. Such expanded testing may help your health care provider better target your therapy to reduce your individual risk.

Cholesterol Levels

Blood cholesterol is measured in milligrams per deciliter (mg/dL). A deciliter is one-tenth of a liter). NCEP defines a "desirable" total cholesterol level as less than 200 mg/dL and levels for most women stay in the healthy or "desirable" range until middle-age.

But between the ages of 45 and 55, women's average total cholesterol rises to almost 220 mg/dL. Between the ages of 55 and 64, those levels average 240 mg/dL.

Total cholesterol levels between 200 and 239 mg/dL are considered borderline high, meaning you have a "borderline-high" risk of developing heart disease. Levels of 240 mg/dL and above put you in the high-risk category for developing heart disease.

LDL cholesterol levels less than 100 mg/dL are considered "optimal," according to NCEP guidelines. Those between 100 to 129 mg/dL are considered "near optimal/above optimal," that is, they're within the "low risk" category for developing heart disease from high cholesterol. LDL levels of 130 to 159 mg/dL put your heart-disease risk at borderline-high, while levels of 160 to 189 mg/dL put you at high risk. Any LDL level of 190 mg/dL and above are considered very high risk.

As with total cholesterol, the higher the LDL number, the higher your risk for developing heart disease.

HDL-cholesterol levels are interpreted differently. The lower your HDL level, the higher your heart disease risk. A level less than 40 mg/dL is a major risk factor for heart disease. An HDL level of 60 mg/dL or higher is considered protective.

The average HDL cholesterol, and NCEP recommend an HDL cholesterol.

Keep in mind that these recommendations are for healthy individuals, not for women with existing risk factors for heart disease, such as diabetes, kidney disease, being overweight, smoking and having a family history of heart disease. If you are at risk for heart disease, your target cholesterol goals likely will be lower.

For example, having diabetes means your risk of a heart attack in 10 years is as high as if you already had heart disease. That's why NCEP guidelines recommend that those with diabetes be treated as intensively as those with heart disease in terms of medication and lifestyle changes.

Discuss your target cholesterol ranges with your health care professional, including which treatment and prevention options are best for you given your current health status.

Triglycerides

The lipoprotein profile that determines your cholesterol levels also measures another fatty substance called triglycerides. Triglycerides are complex fat molecules that link together three molecules of fat from food. They tend to be short-term transporters of fat and their levels rise right after a meal.

More research is needed to determine whether high triglycerides themselves cause narrowing of the arteries or are simply associated with other risk factors (such as low levels of HDL cholesterol and being overweight). It is known that people with high levels of the "packages" triglycerides usually travel in (vLDLs) are at increased risk. Most people with raised triglycerides are also overweight, and losing weight usually lowers the elevated levels.

Triglyceride levels under 100 mg/dL are considered ideal, according to NCEP guidelines. Levels lower than 150 mg/dL are considered normal. Levels between 150 to 199 mg/dL put you at borderline-high risk for developing heart disease; and triglyceride levels between 200 to 499 mg/dL are considered high risk for heart disease, and a level above 500 is considered very high risk.

Here are "at-a-glance" guidelines for your cholesterol levels according to NHLBI/NCEP guidelines: For additional information visit: www.nhlbi.nih.gov.

Total blood cholesterol levels
Desirable: less than 200 mg/dL
Borderline high: 200 to 239 mg/dL
High: 240 mg/dL or above

LDL blood cholesterol levels
Optimal: less than 100 mg/dL
Near optimal/above optimal: 100 to 129 mg/dL
Borderline-high: 130 to 159 mg/dL
High: 160 to 189 mg/dL
Very high: 190 mg/dL and above

HDL blood cholesterol levels
Optimal: above 60 mg/dL. Levels above 60 mg/dL are considered especially beneficial and can offset risk factors for heart disease, according to NHLBI.
Desirable: 50 to 59 mg/dL. The higher the level, the healthier it is. Major risk factor for heart disease: less than 40 mg/dL.

The American Heart Association (AHA) recommends the following ranges for triglycerides, complex lipoproteins that can also raise your risk for heart disease:

Triglyceride levels
Normal: less than 150 mg/dL
Borderline high: 150 to 199 mg/dL
High: 200 to 499 mg/dL
Very high: 500 mg/dL or higher

The AHA also suggests the following guidelines for cholesterol ranges in children, ages two to 19:

Total blood cholesterol levels
Acceptable: less than 170 mg/dL
Borderline high: 170 to 199 mg/dL
High: 200 mg/dL or greater

LDL blood cholesterol levels
Acceptable: less than 110 mg/dL
Borderline high: 110 to 129
High: 130 or greater

HLD blood cholesterol levels
Greater than or equal to 35 mg/dL

Triglyceride levels
Less than or equal to 150 mg/dL