AHA Scientific Position
Public screenings have the potential to detect large numbers of people with high blood cholesterol levels besides those detected in the physician's office. Public screenings can also raise awareness of high blood cholesterol as a risk factor for coronary heart disease, the first step toward modifying lifestyle to reduce risk. However, public screenings must meet acceptable criteria for recruitment, reliability of measurement of cholesterol levels, appropriate educational information, properly trained staff and referral.
High-density lipoprotein (HDL) cholesterol as well as total cholesterol should be measured. However, if HDL cholesterol measurements aren't available in the screening setting, measuring total cholesterol levels still gives valuable information that can be used to manage cholesterol.
The American Heart Association doesn't recommend mass screenings of blood cholesterol for all children and adolescents.
The American Heart Association shares the concern expressed by federal agencies and congressional committees about the potential dangers of poorly conducted community cholesterol screening programs. Our association recommends focusing on smaller-scale screenings with potential for higher return. There are many such possibilities.
- American Heart Association Heart At Work locales and other business and industry work sites provide major opportunities to reach a high-risk population of middle-aged men and women and especially younger males not yet identified as being at risk. Essential follow-up and referral can be carried out more readily at a job locale. Worksite screenings held cooperatively with a third party such as a hospital, health club, university or medical school are an example. National Heart At Work companies now have access to a national screening referral service. Vendors providing this service conduct screenings that follow American Heart Association guidelines and specifications.
- Screenings targeting low-income, low-education level groups are another way to reach a population that's often under-represented in other voluntary screenings. These programs have great potential for identifying high-risk people who are often from minority communities and not connected to traditional healthcare and information systems. Such screenings may be held in schools, churches, community centers or neighborhood clinics. Again it's preferable that qualified groups conduct the testing.
The American Heart Association urges all Americans to have their physicians determine their total and HDL blood cholesterol levels. This is very important for those people with a family history of heart disease, high blood pressure or stroke.
Getting blood cholesterol and blood pressure measurements should be part of an overall plan of medical care. Physicians or para-professionals working at the direction of the physician should order the cholesterol tests and interpret the result for the patient. The physician should then direct any follow-up care if needed, such as prescribing a diet, exercise program or drug therapy.
Repeat cholesterol tests, specifically those to determine LDL cholesterol and triglycerides, should be completed before therapy is begun, according to the detailed directions and guidelines of the National Cholesterol Education Program and the American Heart Association.
The American Heart Association recommends integrating community health risk assessment programs into the medical care system. These systems should ensure that test results are interpreted by the physician responsible for the patient's care. When cholesterol test results are given directly to a person without also informing that person's physician, there's no guarantee that the person will contact his or her doctor for interpretation follow-up. People who interpret their own cholesterol test result may become unduly frightened or reassured. Screening agencies should refer screenees to their healthcare provider. Follow-up methods such as letters or telephone calls are desirable.
This content was last reviewed on 12/10/2012.