Public Cholesterol Screening (Adults and Children)

Updated:May 12,2014

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. 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 risk.

The American Heart Association doesn't recommend mass screenings of blood cholesterol for all children and adolescents. See Children and Cholesterol for more information.

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 Fit-Friendly Worksites and other business and industry worksites 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 location. Worksite screenings can be held cooperatively with a third party such as a hospital, health club, university or medical school. 
  • Screenings that target low-income, low-education groups are another way to reach a population often under-represented in 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. It's preferable that qualified groups conduct the testing.
Public screenings should be at a reasonable cost and at convenient sites that efficiently accommodate the number of people being screened and ensure quality-control procedures and privacy. Screenings should include reliable verbal and printed information about cholesterol from knowledgeable staff who can provide referrals or follow up.

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 your blood cholesterol, blood pressure, body mass index and fasting blood sugar measured regularly should be part of your overall medical care plan. Your doctor can order these tests and discuss the results with you. After discussing your risks and overall health, you and your physician can determine the best prevention and treatment strategy for you.

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 patients to their healthcare provider. Follow-up methods such as letters or telephone calls are desirable.

This content was last reviewed on 04/16/2014.


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