National Cholesterol Education Program (NCEP) guidelines for a cholesterol test

The National Cholesterol Education Program (NCEP), an expert group of doctors and scientists affiliated with the National Institutes of Health, recommends that all people older than age 20 have a fasting blood test called a lipoprotein profile every 5 years. NCEP guidelines suggest:1

  • If total cholesterol is less than 200 mg/dL (5.17 mmol/L) and HDL cholesterol is at least 40 mg/dL (1.04 mmol/L), testing for high cholesterol should be repeated every 5 years.
  • If total cholesterol is less than 200 mg/dL (5.17 mmol/L) but HDL cholesterol is less than 40 mg/dL (1.04 mmol/L), a more extensive cholesterol test may be done (lipoprotein analysis).
  • If total cholesterol is between 200 mg/dL to 239 mg/dL (5.17 mmol/L to 6.18 mmol/L), you are considered to have borderline-high cholesterol. The next step depends on your HDL level and whether you have other coronary artery disease (CAD) risk factors.
    • If HDL cholesterol is at least 40 mg/dL (1.04 mmol/L) and there are fewer than two other CAD risk factors, cholesterol testing should be done again in 1 to 2 years.
    • If HDL cholesterol is less than 40 mg/dL (1.04 mmol/L) or there are two or more other CAD risk factors, a more extensive total cholesterol test called a lipoprotein analysis may be done.
  • If total cholesterol is 240 mg/dL (6.21 mmol/L) or more, a more extensive cholesterol test (lipoprotein analysis) may be done.


  1. Grundy SM, et al. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19): 2486–2497.

Last Updated: August 13, 2009

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