Lipids
Total cholesterol
Total cholesterol measures all the cholesterol carried in the blood across the various lipoprotein fractions, including LDL, HDL and VLDL. At the point of care it is read from a capillary finger-prick sample, often as part of a lipid panel alongside HDL, triglycerides and a calculated LDL.
Why it is measured
Total cholesterol is a core input to cardiovascular risk assessment and to monitoring of lipid-lowering therapy. Point-of-care measurement supports screening, case finding and same-visit review in primary care, pharmacy and community settings without waiting for a laboratory turnaround.
| Typical range | Indicative adult guide values: a desirable total cholesterol is generally below 5.0 mmol/L in the general population, with many CVD prevention pathways targeting lower. Values around 5.0 to 6.5 mmol/L are commonly regarded as borderline and above this as raised. UK guidance flags a total cholesterol above 9.0 mmol/L for specialist assessment of possible familial hypercholesterolaemia. POCT analysers also have a defined reportable measuring interval, for example roughly 2.6 to 12.9 mmol/L on some cassette systems. Cut-offs are interpretive rather than a fixed normal range, and values vary by method, device and population, so confirm against laboratory testing where clinically indicated. |
|---|---|
| Sample | Capillary whole blood from a finger-prick is the typical point-of-care sample, applied to a test strip or cassette. Venous serum or plasma can also be used on some platforms. A non-fasting sample is acceptable for total cholesterol in most screening contexts. |
| Turnaround | Approximately 1 to 5 minutes from sample application to result, depending on the device and cassette. |
Point of care devices that report it
- Abbott Cholestech LDX System (Lipid Profile cassettes)
- PTS Diagnostics CardioChek PA and CardioChek Plus
- Abbott Afinion 2 (Lipid Panel cartridge)
- ACON Mission Cholesterol meter
Questions, answered
Does the patient need to fast before a point-of-care total cholesterol test?
For total cholesterol alone, fasting is generally not required and non-fasting samples are widely accepted for screening. Fasting can matter more when triglycerides and calculated LDL are part of the same panel, since triglycerides are more affected by recent meals. Follow your local lipid testing protocol for when a fasting sample is preferred.
How well do point-of-care total cholesterol results agree with the laboratory?
Published method comparisons report good agreement for total cholesterol on common POCT analysers, with correlation coefficients typically high and lower imprecision than for HDL. Agreement still depends on correct technique, in-date cassettes and routine quality control. Where a result will drive a significant clinical decision, confirm with a venous laboratory sample.
Why might a point-of-care total cholesterol differ from a previous laboratory value?
Differences can arise from method and device variation, capillary versus venous sampling, biological day-to-day variation and pre-analytical factors such as sample handling. This is an operational and educational point about comparability and is not patient-specific interpretation. Trend monitoring is most reliable when the same method and sample type are used consistently.