Many people leave a check-up with one figure in their head: "my cholesterol is 5.2". It is a useful starting point, but it is only the sum of several different particles that behave in different ways. A cholesterol test that breaks that number down gives a much clearer picture of what is circulating in your blood.
High cholesterol usually causes no symptoms, and the NHS is clear that the only way to find out your levels is a blood test. That is why it is worth understanding what the full profile shows before you order one.
What a full cholesterol test measures
The Cholesterol Lipid Profile in the BPR Clinic catalogue is processed by the LML laboratory and reports seven results:
- Total cholesterol: the overall amount in the blood.
- HDL cholesterol: often called "good" cholesterol, because it is linked to a lower likelihood of heart problems.
- LDL cholesterol: often called "bad" cholesterol, the main cholesterol carried into artery walls.
- Non-HDL cholesterol: total cholesterol minus HDL, which captures every particle that is not HDL.
- Triglycerides: a different type of blood fat, closely tied to diet, alcohol and weight.
- Total cholesterol to HDL ratio and HDL percentage: two ways of showing the balance between the protective and the less helpful fractions.
If you only want the overall figure, the catalogue also lists Cholesterol - Total on its own. It is simpler, but it cannot tell you whether a result comes mostly from HDL or from the other particles.
Why non-HDL cholesterol gets so much attention
A review of the literature on non-HDL cholesterol explains its appeal: it includes LDL plus the triglyceride-rich particles, their remnants and lipoprotein(a), so it gathers almost everything with the potential to build up in arteries (Raja et al., 2023). It is easy to calculate and does not depend on fasting. The NHS now lists non-HDL alongside total and HDL cholesterol when it explains results.
Where VLDL fits in
VLDL stands for very low-density lipoprotein. It is the particle that carries most triglycerides made by the liver. As it releases its fat, it becomes smaller "remnant" particles. A European Atherosclerosis Society consensus describes these triglyceride-rich lipoproteins and their remnants as contributors to atherosclerotic cardiovascular disease (Ginsberg et al., 2021).
The VLDL Cholesterol test measures this fraction directly. It is not a routine first test. It tends to be added when triglycerides are raised or when a professional wants a closer look at that part of the profile. Results take longer than the standard profile: the LML lists around 8 days after the sample reaches the laboratory.
Reading the numbers with care
The NHS gives a guide to healthy levels for healthy adults: total cholesterol below 5 mmol/L, HDL above 1.0 mmol/L for men or above 1.2 mmol/L for women, and non-HDL below 4 mmol/L. It also notes that the right target for each person depends on age, health conditions and overall cardiovascular risk.
That last point matters. In the UK, NICE guidance asks clinicians to combine a full lipid profile with blood pressure, smoking status, weight, diabetes status and other factors to estimate risk, rather than reading cholesterol in isolation. The same profile can mean different things for a 30-year-old non-smoker and for a 60-year-old with high blood pressure.
Family history is another piece. According to the LML, about 1 in 250 people have very high cholesterol caused by an inherited condition called familial hypercholesterolaemia. NICE has a dedicated guideline on identifying it, which uses clinical findings, a full lipid profile and family history together.
When a cholesterol test tends to make sense
Cholesterol testing is often part of a routine health check from the mid-twenties onwards. It is also commonly considered when:
- a parent, brother or sister had heart problems or a stroke at a young age;
- a relative is known to have very high cholesterol;
- there are other factors such as raised blood pressure, diabetes or excess weight;
- someone is following up on lifestyle changes or on medicine prescribed by their doctor.
The NHS notes that cholesterol tends to be higher with age, after the menopause and in people of South Asian or sub-Saharan African origin, and that it can run in families.
How often
As a general orientation, adults with normal results often repeat the profile every five years, moving to once a year from around 40. That rhythm changes with your history and any treatment, so talk to a healthcare professional about the interval that fits you.
