What Does a High Cholesterol Diagnosis Mean?

High cholesterol is diagnosed with a fasting lipid panel blood test (though non-fasting testing is increasingly used for initial screening). The key values are:

• Total cholesterol — below 5.5 mmol/L is generally desirable in Australia
• LDL cholesterol — the primary treatment target. The appropriate target depends on your cardiovascular risk — not a universal number
• HDL cholesterol — above 1.0 mmol/L for men, above 1.3 mmol/L for women. Higher is generally better Source: Heart Foundation Australia
• Triglycerides — below 1.7 mmol/L fasting is desirable. Source: Heart Foundation Australia Very high triglycerides (above 5.6 mmol/L) increase pancreatitis risk

Familial hypercholesterolaemia (FH) is a genetic condition causing very high cholesterol from birth. It is underdiagnosed in Australia — the Dutch Lipid Clinic Network score is used to estimate its probability based on LDL level, family history, and physical findings.

Management depends on your LDL level and overall cardiovascular risk:

• Dietary changes — reducing saturated fat (found in red meat, full-fat dairy, processed foods) and replacing it with unsaturated fat (olive oil, avocado, nuts, fish) can lower LDL by 5–15%
• Increasing soluble fibre — oats, legumes, psyllium
• Exercise — improves HDL levels
• Statins — the most effective and widely used cholesterol-lowering medication. They reduce cardiovascular events (heart attack and stroke), not just LDL numbers. PBS-subsidised in Australia for people at sufficient cardiovascular risk
• Ezetimibe, PCSK9 inhibitors — used when statins are insufficient or not tolerated

A Heart Health Check (MBS item 699) is available every 2 years to Australians aged 45–79 (or 30–79 for Aboriginal and Torres Strait Islander peoples) — it includes a lipid panel and cardiovascular risk assessment.