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Do Heart Patients Get Too Many Cholesterol Tests?

Unnecessary screenings contribute to rising U.S. health costs, study suggests
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WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

MONDAY, July 1 (HealthDay News) -- Many U.S. heart patients may be getting their cholesterol levels checked unnecessarily, a new study suggests.

Statistics on more than 35,000 patients with coronary heart disease treated in a Houston-based Veterans Affairs network suggest this is an area of over-testing that's contributing to the nation's soaring medical costs, the study authors said.

At this one network of seven hospitals, the cost of redundant cholesterol blood tests amounted to more than $200,000 in one year, the study found.

"These results represent health care resource overuse and possibly their waste," said lead researcher Dr. Salim Virani, a cardiologist at the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

The study, published online July 1 in JAMA Internal Medicine, zeroed in on almost 28,000 patients taking statin drugs that were keeping their cholesterol levels in check -- less than 100 milligrams of cholesterol per deciliter of blood.

Over 11 months, repeat tests were ordered for one-third of those patients even though their medication had not been increased, the researchers found.

In all, nearly 13,000 additional tests were performed at about $16 each, bringing the total cost for this one group of hospitals to almost $204,000.

"Apart from the costs associated with these lipid panels, this also carries with it the cost for the patient's time to undergo a repeat blood test and cost for the health care provider's time to follow up on these results after redundant testing and to inform the patient about these results," said Virani.

Most of those who underwent repeat testing had a history of diabetes, high blood pressure and more frequent doctor visits, the research team found. The extra tests likely gave some of these patients a measure of comfort, the study authors noted.

The study drew mixed reactions from other experts.

Current national guidelines recommend that patients with coronary heart disease have their cholesterol checked every four to six months, said Dr. Gregg Fonarow, professor of cardiology at the University of California, Los Angeles and a spokesman for the American Heart Association.

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Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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