Diagnosing High Cholesterol

Diagnosing high cholesterol and cholesterol abnormalities

A simple blood test at Virginia Mason Hospital & Seattle Medical Center will determine if your cholesterol profile is abnormal. Your physician may run other, more specific blood tests.

Advanced Lipid testing

The VAP® (Vertical Auto Profile) Test, NMR Lipoprofile® Test and the Berkeley HeartLab® profile are all commercially available expanded cholesterol tests that can help determine a person's risk of developing heart disease. These tests can be useful in assessing people who are at intermediate or unknown risk (someone with no information on family history), including those with inherited risk factors who often develop early heart disease.

Like routine tests, the Advanced Lipid Tests measure total cholesterol, HDL ("good" cholesterol), LDL ("bad" cholesterol), and triglycerides. The tests also measure cholesterol subclasses that may play important roles in the development of heart disease. This additional information allows your health-care provider to improve the detection of heart disease risk, and will often help in developing a specific treatment plan.

Lipoprotein (a)

Lipoprotein (a), also known as Lp(a) is another cholesterol protein subclass. This cholesterol particle is like a "sticky" LDL (bad cholesterol), which may be measured with specialized testing. A very high level of this particle significantly increases a person's risk for heart attack and stroke. Also, the "statin" cholesterol-lowering drugs do not lower Lp(a), so measuring Lp(a) can help you and your doctor understand your treatment options.

More about Lp(a)


Homocysteine is a normal-circulating amino acid (protein building block). When this blood component increases to a high level in the bloodstream, it can contribute to the build-up of plaque in the blood vessels, but does not contribute to heart disease in most people with a normal diet. The homocysteine excess can be inherited, but Vitamin B deficiency, smoking, kidney disease, and some drugs can raise the homocysteine, as well.