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ealth Hint #355

When--And How Often--To Have a Cholesterol Test (and Other Routine Tests)

© American Institute for Preventive Medicine, DonR. Powell PhD

Excerpted from "A Year of Health Hints"
365 Practical Ways to Feel Better and Live Longer

Is it time for a mammogram or blood pressure reading? Most people have only a very general sense of when routine medical tests are needed. They tend to rely on a reminder from their physicians. But what if you don't have a personal physician and haven't seen one for years? The following table will help in anticipating when important medical tests should be done.

Here is what the tests will check.

Blood Pressure Test - Checks two kinds of pressure within the blood vessels. The higher number (systolic blood pressure) gauges the pressure when your heart is pumping and the lower number (diastolic blood pressure) represents the pressure between heartbeats. High blood pressure is a symptoms disease that can lead to a heart attack and/or a stroke.

Vision - Checks for marked changes or degeneration of eye functioning.

Pap smear - Is used to detect the early signs of cervical cancer, uterine cancer and herpes.

Mammography - An X-ray to detect breast tumors or problems.

Professional Breast Exam - A physician or nurse examines the breasts for signs of abnormalities.

Digital Rectal exam - Checks for early signs of colorectal and/or prostate abnormalities including cancer.

Stool Blood Test - Checks for early signs of colorectal abnormalities including cancer.

Sigmoidoscopy - Checks for early signs of colorectal abnormalities and cancer.

Cholesterol blood Test - Checks the levels of fatty deposits (cholesterol) in the blood. High cholesterol levels are linked to heart disease.

Glaucoma Screening - Checks for increased pressure within the eye. Glaucoma can result in blindness if not treated.

Guidelines for Routine Tests

Ages 20-29 30-39 40-49 50 and Older
Physical Exam        
Blood Pressure        
Pap Test1        
Breast Self-Examination Monthly Monthly Monthly Monthly
Professional Breast Examination        
Testicular Self-Exam (Men) Discuss With Your Doctor
Digital Rectal Exam     Discuss With Your Doctor
Stool Blood Test        
Cholesterol Blood Test3        
Glaucoma Screening4        
Regular Dental Checkup        
  Every Year   Every 1-2 years   Every 2-3 years   Every 3-5 years

NOTE: Recommendations for routine medical exams may vary. These apply only to healthy people who do not have symptoms of illness. If you have an increased risk of a particular illness, testing may need to be done sooner or more often. Extra tests may also be need to be done. Follow your doctor's advice. Also, check with your insurance company to see if and when tests are covered.

1. Pap tests should start at age 18 or under age 18 if sexual activity has begun. They should be given every year until tests are normal 3 years in a row. Thereafter, pap smears should be given at least every three years. [Note: The American College of Obstetricians and Gynecologists recommend an annual Pap Smear.]
2. As recommended by The National Cancer Institute. Check with your doctor for his or her recommendations.
3. The National Cholesterol Education Program (NCEP) recommends a blood cholesterol test at least once every 5 years, and that high-density lipoprotein (HDL) be part of the initial cholesterol testing.
4. Glaucoma screening is recommended earlier for African Americans. It should be done every 2-3 years between the ages of 40 and 49.

SOURCE FOR TEXT AND TABLE: "Healthy Self" The Guide to Self-Care and Wise Consumerism (Farmington Hills, Mich.: American Institute for Preventive Medicine, 1996).

Know Your Cholesterol Levels

Average doesn't necessarily mean healthy, especially when you're talking about cholesterol, a fat-related substance found in the blood. Too much cholesterol can build up and form artery-clogging plaques, slowing blood to a trickle and ending in a heart attack that could be fatal.

According to a panel of experts convened by the National Heart, Lung, and Blood Institute, cholesterol should be 200 milligrams per deciliter or lower. Yet the average cholesterol level for men in the United States is 211, and for women, it's 215. So if your doctor tells you your cholesterol is "normal" or "average," ask for the exact numbers, and if it's elevated, take steps to reduce it. (Cholesterol levels of 200 to 240 milligrams per deciliter put adults at moderate risk for heart disease; levels of 240 or higher constitute a high risk.)

Better yet, ask for a blood test that measures not only your total cholesterol but also your triglycerides (another kind of blood fat), HDL (high-density lipoprotein) cholesterol, a protective kind of fat, and LDL (low-density lipoprotein) cholesterol. Ideally, your triglyceride level should be 160 milligrams per deciliter or lower.

The more HDL, the better, and the less LDL, the better. An HDL below 35 is cause for concern; so is an LDL over 130. Also, the ratio of total cholesterol to HDL cholesterol ideally should be 3.5 or less. (To calculate your ratio, divide the total cholesterol number by the HDL number.) A ratio of 4.0 to 5.0 constitutes about average risk.

Most people can improve their cholesterol and triglyceride readings by eating less dietary fat, not smoking, getting more exercise, avoiding overweight, consuming a limited amount of alcohol and sweets, and eating certain kinds of food high in fiber. (For more details on a heart-healthy diet, see chapter 4, Eating for Better Health.)

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