When Should You Check Cholesterol? UK Screening Guidelines

Introduction

Cholesterol is a word most of us have heard many times. We know it is something to keep an eye on. Yet surprisingly few people know exactly when they should have their levels tested.

The question “when should you check cholesterol?” is one of the most common health queries in the UK. The answer depends on your age, your personal risk factors, and your family history. Understanding the guidelines helps you plan ahead and take a proactive approach to your heart health.

In this guide, we explain UK screening recommendations, who should consider testing earlier, how often to monitor your levels, and how a cholesterol blood test fits into your overall preventive health plan.

What Is Cholesterol?

Cholesterol is a fatty substance found in your blood. Despite its reputation, your body actually needs cholesterol to function properly. It plays a role in building healthy cells, producing hormones, and making vitamin D.

There are two main types:

LDL (low-density lipoprotein) – often called “bad” cholesterol. High levels may contribute to a build-up in your arteries over time

HDL (high-density lipoprotein) – often called “good” cholesterol. It helps carry excess cholesterol back to the liver for removal

The balance between these types matters. Too much LDL cholesterol, relative to HDL, may gradually increase health risks over time.

Why Cholesterol Testing Matters

One of the most important things to understand about cholesterol is that high levels produce no symptoms. You cannot feel high cholesterol. There is no pain, no visible sign, and no way to know without testing.

This is why cholesterol testing matters so much. It is the only reliable way to find out your levels. Early awareness gives you the opportunity to make informed choices about your lifestyle and health.

Understanding when should you check cholesterol is the first step towards taking control of this important aspect of your wellbeing.

UK Guidelines for Cholesterol Screening

The UK has a structured approach to cholesterol screening, primarily through the NHS Health Check programme.

NHS Health Check

Offered every 5 years to adults aged 40 to 74 in England

Includes a cholesterol test as part of a broader cardiovascular risk assessment

Also checks blood pressure, blood sugar, and other health markers

Part of a national preventive health programme

Before Age 40

Cholesterol screening is not routinely offered to everyone under 40

Testing is recommended based on individual risk factors

Those with family history or other concerns can request testing through their GP or access private testing

These cholesterol test guidelines and cholesterol testing guidelines provide a framework, but your personal circumstances may mean that earlier or more frequent testing is appropriate. The cholesterol screening age of 40 is a general starting point, not a universal rule.

When Should You Check Cholesterol – General Guidance

So when should you check cholesterol? Here is a simple overview:

By age 40 – most adults should have had their cholesterol tested at least once

Earlier if you have risk factors – family history, diabetes, high blood pressure, or other concerns

Every 5 years – if your levels are within the normal range and you have no additional risk factors

More frequently – if levels are raised, you have risk factors, or you are being monitored

When should you check cholesterol really comes down to a combination of age, risk, and personal health goals. The guidelines provide a helpful framework, but you can always choose to test earlier or more often.

Factors That Suggest Earlier Testing

While the general recommendation is to begin testing by age 40, several factors suggest that earlier testing may be beneficial. Knowing when to test cholesterol, when to get cholesterol checked, and when to have cholesterol test appointments is particularly important if you have:

Family history of early heart disease – a parent or sibling affected before age 55 (men) or 65 (women)

A close relative with high cholesterol – particularly familial hypercholesterolaemia

Overweight or obesity – excess weight can raise LDL cholesterol

High blood pressure – increases overall cardiovascular risk

Diabetes or prediabetes – closely linked to cholesterol levels

Smoking – lowers HDL cholesterol and damages blood vessels

South Asian ethnicity – research suggests a higher risk of cardiovascular conditions

If any of these apply to you, speaking to a healthcare professional about earlier testing is a sensible step.

Family History Matters

Family history is one of the most significant factors in determining when should you check cholesterol. If a parent or sibling developed heart disease at a young age, or if a family member has been diagnosed with familial hypercholesterolaemia (FH), your own cholesterol levels deserve attention.

Familial hypercholesterolaemia is a genetic condition that causes very high cholesterol levels from a young age. It affects approximately 1 in 250 people in the UK, though many remain undiagnosed.

If FH runs in your family, testing in early adulthood – or even childhood in some cases – can provide important information. Early awareness supports timely action and informed decision-making.

How Often Should Cholesterol Be Checked?

The question of how often check cholesterol depends on your individual circumstances. Here is a general guide to cholesterol check frequency and cholesterol testing frequency:

Healthy Adults with Normal Levels

Every 5 years is a typical recommendation

Consistent with the NHS Health Check programme

Provides regular monitoring without unnecessary frequency

Those with Slightly Raised Levels

Every 1 to 3 years depending on the degree of elevation and overall risk

Allows for monitoring of any changes

May be combined with lifestyle modifications

Those on Cholesterol Medication

As advised by your healthcare professional

Typically annually or following any medication changes

Helps assess whether medication is having the desired effect

How often should cholesterol be checked and how often to test cholesterol are questions best answered in the context of your personal health profile. Your healthcare professional can advise on the frequency that is right for you.

The NHS Health Check Programme

The NHS Health Check is a free health assessment available to adults in England aged 40 to 74 who do not already have a diagnosed cardiovascular condition. It includes lipid profile testing as a core component.

What the NHS Health Check includes:

Cholesterol test – a complete lipid profile

Blood pressure measurement – checking for hypertension

Diabetes risk assessment – including blood sugar or HbA1c

BMI and weight assessment – body composition check

Cardiovascular risk score – calculated using your results

The programme is designed to catch potential health risks early. However, availability can vary by area, and not everyone receives an invitation automatically. You can contact your GP surgery to check your eligibility. For more detail on what cholesterol tests involve, read our guide on NHS Health Check information.

What If You Are Under 40?

If you are under 40, routine cholesterol screening is not typically offered through the NHS. However, this does not mean testing is unnecessary.

You can request a cholesterol test through your GP if you have risk factors

Private testing is available without a referral

If you have a strong family history, early testing provides valuable baseline information

Some people simply prefer to know their levels as part of proactive health management

Being under 40 does not mean cholesterol is not relevant. Understanding when should you check cholesterol at a younger age is particularly important if risk factors are present.

What If You Are Over 74?

The NHS Health Check programme ends at age 74, but cholesterol testing remains relevant beyond this age.

There is no upper age limit for the value of cholesterol monitoring

Cholesterol levels continue to affect cardiovascular health in older adults

Testing can support conversations with your healthcare professional about ongoing health management

Private testing offers a convenient option for those who wish to continue monitoring

What Does a Cholesterol Test Measure?

A cholesterol test – also known as a lipid profile – measures several different types of fats in your blood:

Total cholesterol – the overall level of cholesterol in your blood

LDL cholesterol – the “bad” cholesterol that can build up in arteries

HDL cholesterol – the “good” cholesterol that helps remove excess cholesterol

Non-HDL cholesterol – all types of “bad” cholesterol combined, considered a useful overall measure

Triglycerides – another type of fat in the blood, often linked to diet and lifestyle

Total cholesterol/HDL ratio – a calculated indicator of cardiovascular risk

Together, these markers provide a comprehensive picture of your lipid health.

Understanding Your Results

Cholesterol results in the UK are measured in millimoles per litre (mmol/L). Here are general target levels used by many healthcare professionals:

Total cholesterol – desirable below 5 mmol/L

LDL cholesterol – desirable below 3 mmol/L (below 2 mmol/L if at higher risk)

HDL cholesterol – higher is better; above 1 mmol/L for men, above 1.2 mmol/L for women

Non-HDL cholesterol – desirable below 4 mmol/L

Important: These are general targets used widely across the UK. Your healthcare professional will interpret your results based on your personal health profile, risk factors, and medical history. Individual targets may differ.

What If Your Cholesterol Is High?

Receiving a high cholesterol result does not necessarily mean something is wrong. Many factors affect cholesterol levels, and a single reading is just one piece of the picture.

Lifestyle factors such as diet, exercise, and weight play a significant role

Some people have genetically higher cholesterol regardless of lifestyle

Changes to diet and physical activity can often help improve levels

In some cases, a healthcare professional may discuss medication options

The key is that knowing your levels empowers you to take appropriate action. A high result is information, not a cause for alarm.

Lifestyle Factors That Affect Cholesterol

Several everyday factors can influence your cholesterol levels:

Diet – foods high in saturated fat are associated with higher LDL cholesterol. Reducing saturated fat and increasing fibre may help

Physical activity – regular exercise may help support HDL cholesterol levels and your overall lipid profile

Weight – carrying excess weight is associated with higher LDL and lower HDL levels

Smoking – may lower HDL cholesterol and is associated with damage to blood vessel walls

Alcohol – excessive consumption may raise cholesterol and triglyceride levels

Understanding these factors helps put your cholesterol results into context and highlights areas where positive changes may be possible.

Children and Cholesterol Testing

Cholesterol testing in children is rare and only considered in specific circumstances:

When there is a strong family history of familial hypercholesterolaemia

If a parent has been diagnosed with very high cholesterol

Testing is usually carried out in specialist settings

It is not routine for most children

If you are concerned about cholesterol in your family, a healthcare professional can advise whether testing for children is appropriate.

Private Cholesterol Testing

Private cholesterol testing offers a convenient alternative for anyone who wants to check their levels without waiting for an NHS Health Check or GP appointment.

Available without a referral

Fast access to appointments – no waiting lists

Complete lipid profile included

Clear results with reference ranges

Results sent directly to you

Freedom to discuss findings with any healthcare professional of your choice

You can view the full range of tests available, including cholesterol panels, on our private cholesterol test page.

Symptoms of Very High Cholesterol

It is important to note that most people with high cholesterol experience no symptoms whatsoever. This is why testing is so essential.

In rare cases, extremely high cholesterol levels – often associated with familial hypercholesterolaemia – can produce visible signs:

Xanthomas – yellowish fatty deposits that can appear on the skin, particularly around the eyes, elbows, or tendons

Arcus senilis – a grey-white ring around the coloured part of the eye

If you notice any of these signs, consult a healthcare professional for further assessment.

When to Seek Medical Advice

We encourage you to seek medical advice if:

You experience symptoms that could be related to cardiovascular health, such as chest pain or discomfort

You have shortness of breath that is unusual for you

You have a strong family history of early heart disease

You have questions about cholesterol medication or management

If symptoms are severe or sudden, seek urgent medical care through appropriate healthcare services.

Making Informed Choices About Cholesterol Testing

Understanding when should you check cholesterol is about putting yourself in control of your health. You do not need to wait for symptoms – because there usually are not any. You simply need to understand the guidelines, consider your personal risk factors, and take action at the right time.

Cholesterol testing is one of the simplest and most informative health screenings available. It provides a clear snapshot of your lipid health and empowers you to make decisions that support your long-term wellbeing.

Consider exploring our health screening packages for comprehensive options that include cholesterol alongside other important health markers. Regular monitoring is a positive step, and you can take it at your own pace.

Frequently Asked Questions

When should you check cholesterol levels?

Most adults should have their cholesterol checked by age 40. If you have risk factors such as family history, diabetes, high blood pressure, or obesity, earlier testing is recommended. The NHS Health Check programme offers testing every 5 years from age 40 to 74.

At what age should I start checking cholesterol?

The general recommendation is to begin cholesterol screening by age 40 through the NHS Health Check. However, if you have a family history of high cholesterol or early heart disease, testing in your twenties or thirties may be appropriate. Your healthcare professional can advise based on your individual risk.

How often should cholesterol be checked?

For healthy adults with normal levels, every 5 years is a common recommendation. If your cholesterol is raised or you have risk factors, testing every 1 to 3 years may be more appropriate. Those on cholesterol medication should follow their healthcare professional’s guidance, which is typically annually.

What is the NHS recommendation for cholesterol testing?

The NHS Health Check programme offers a free cardiovascular risk assessment, including cholesterol testing, every 5 years for adults aged 40 to 74 in England. This includes a full lipid profile alongside blood pressure, blood sugar, and BMI checks.

Can I check my cholesterol before age 40?

Yes. While the NHS Health Check is aimed at those aged 40 and over, you can request a cholesterol test from your GP if you have concerns or risk factors. Private testing is also available without a referral and can be arranged at any age.

How do I know if I need a cholesterol test?

Consider a cholesterol test if you are over 40 and have not been tested recently, if you have a family history of heart disease or high cholesterol, if you have diabetes, high blood pressure, or if you smoke. Even without risk factors, knowing your levels provides helpful baseline information.

What does a cholesterol test measure?

A cholesterol test, also called a lipid profile, measures total cholesterol, LDL cholesterol, HDL cholesterol, non-HDL cholesterol, triglycerides, and the total cholesterol to HDL ratio. Together, these markers give a comprehensive picture of your lipid health.

What is a normal cholesterol level in the UK?

General UK targets are total cholesterol below 5 mmol/L, LDL below 3 mmol/L, HDL above 1 mmol/L for men and 1.2 mmol/L for women, and non-HDL below 4 mmol/L. However, individual targets may differ based on your personal health profile and risk factors.

How often should I test if my cholesterol is high?

If your cholesterol is raised, your healthcare professional may recommend testing every 1 to 3 years, depending on the level and your overall risk. If you are taking medication, annual testing is typical, or more frequently after medication changes.

Is cholesterol testing free on the NHS?

Cholesterol testing is included as part of the NHS Health Check, which is free for eligible adults aged 40 to 74 in England. Outside of this programme, your GP may offer testing if clinically indicated. Private testing is also available for a fee.

Can I get a private cholesterol test without seeing a GP?

Yes. Private cholesterol testing is available without a GP referral. You can book an appointment directly, receive your results with clear reference ranges, and discuss them with any healthcare professional of your choice.

What affects how often I should test cholesterol?

Several factors influence testing frequency, including your age, current cholesterol levels, family history, presence of other risk factors such as diabetes or high blood pressure, lifestyle factors, and whether you are taking cholesterol medication. Your healthcare professional can help determine the right schedule for you.

*This content has been reviewed by the clinical team at Private Blood Tests London.*

*This article is for general information only and does not replace professional medical advice. Always consult a qualified healthcare professional for personal medical guidance.*