How to read a lipid panel

Cholesterol results help estimate the risk of heart attack and stroke. They are read together with the patient's overall risk, not as isolated numbers.

Step by step

1. Check the sample

   A non-fasting sample is fine for most screening. Repeat it fasting if triglycerides are over 400 mg/dL. [1]

2. Look at LDL

   LDL is the main treatment target. An LDL of 190 mg/dL or more usually calls for high-intensity statin therapy and a check for familial hypercholesterolemia. [1]

3. Look at HDL

   Low HDL raises risk. Raising HDL with drugs has not been shown to prevent heart events. [1]

4. Look at triglycerides

   High triglycerides link to diabetes, obesity and alcohol. Levels of 500 mg/dL or more raise the risk of pancreatitis. [1]

5. Calculate non-HDL

   Non-HDL cholesterol is total cholesterol minus HDL. It is useful when triglycerides are high. [1]

6. Estimate overall risk

   For adults without heart disease, use a guideline-recommended 10-year risk calculator. Add risk factors such as diabetes, smoking, kidney disease and family history. [2]

7. Check secondary causes

   Low thyroid, diabetes, kidney disease, liver disease and some drugs raise lipids. Treat the cause as well. [1]

Common errors

• Treating the numbers without estimating overall risk.
• Missing familial hypercholesterolemia when LDL is 190 or higher.
• Requiring fasting for every lipid test.

Typical adult categories (mg/dL) [1]

Sources

1. NCCPA PANCE Content Blueprint
2. AAMC Core Entrustable Professional Activities (Core EPAs)

Facts and steps follow AAMC Core Entrustable Professional Activities (Core EPAs); NCCPA PANCE Content Blueprint. VMS is not affiliated with these organizations. Updated: 2026-10-11.