High Cholesterol: Lab Reports, Medication and Movement in One Place

No. Cholesterol can only be measured with a blood test. Sam doesn't measure blood values, and an Apple Watch doesn't give you a cholesterol reading either. Sam reads the numbers from lab reports that you add yourself as a photo or PDF, and only after you agree.

Total cholesterol adds up all the cholesterol in your blood. LDL cholesterol is the value that the treatment goals in the European guideline mostly refer to. HDL cholesterol is often called the good one, but the German health institute IQWiG says a protective effect has not been confirmed in newer studies. Triglycerides are another type of blood fat. Doctors call raised blood fats dyslipidaemia. IQWiG also notes there is no single value above which risk suddenly rises, and what your numbers mean for you is for your doctor to say.

Usually not. The NHS says most people do not need to fast, and the 2019 European guideline (ESC/EAS) says non-fasting samples seem to have at least the same prognostic value for general risk screening. On average, triglycerides run about 27 mg/dL (0.3 mmol/L) higher after eating; if they are very high, your clinic may repeat the test fasting. Your clinic tells you what applies to your appointment, for example if a fasting glucose is measured at the same visit.

Your doctor sets that for you. As one example, the NHS Health Check in England includes a cholesterol test and is offered every five years to adults aged 40 to 74 who do not already have a condition such as heart disease or inherited high cholesterol and are not taking cholesterol-lowering medicine; people who do are followed up through regular check-ups. Sam keeps every lab report you add and, if both reports print the same unit, shows what changed compared with the previous one.

The range printed on a lab report is usually a general reference point from the lab, not tailored to your personal risk. Whether a goal applies to you, and which, depends on your overall cardiovascular risk and is for your doctor to set. Guidelines also differ: the European guideline (ESC/EAS) gives LDL goals by risk group, while the German GPs' society DEGAM called an LDL-target strategy unnecessarily complex in a 2024 statement. Sam only shows the range printed on your report, sets no goal of its own and calculates no risk, so it cannot tell you whether you have reached your personal goal.

Whether to take preventive medication when you have not had a heart attack or stroke is, as IQWiG puts it, a matter of personal weighing-up; IQWiG recommends treatment for people who have already had a heart attack, stroke or other cardiovascular disease, and for people with inherited high cholesterol. Worries, possible side effects and any question about stopping belong in a conversation with your doctor. Sam doesn't take any of that on: it reminds you at the times you enter for your medication and keeps a record of when you ticked off a dose. You can note complaints in the symptom diary. Sam doesn't link them to a medicine or check interactions, and which dose applies is for your doctor to decide. Do not stop a prescribed medicine on your own.

European guidelines list not smoking, a diet low in saturated fat and regular physical activity as part of lifestyle advice for blood fats. How much that matters for you is for your doctor to judge. Sam shows steps, active energy and exercise minutes from Apple Health as a trend over weeks, and its movement and exercise features add a short activity questionnaire once a month. That is a display of your data, not a measure against high blood fats. Sam doesn't measure what you eat and doesn't link your activity to your lab values. For high cholesterol despite a healthy diet, see High cholesterol but eat healthy? When it's genetic.

Your latest lab reports, a current medication list and the answer to whether a parent or sibling had a heart attack or stroke early in life all fit an appointment. IQWiG names early cases in the family as a risk factor. You add the reports to your Health Vault in Sam; Sam reads the values only after you agree. Sam files some rows under the wrong value, for example VLDL cholesterol under total cholesterol; check the name and number of every row against the original report. You create the monthly report yourself; it only counts your reports and values, not the values themselves. High cholesterol doesn't usually cause symptoms. Chest pain or pressure is always a reason to call the emergency number straight away (112 in the EU, 999 in the UK, 911 in the US); it can spread to the arm, neck or jaw and come with shortness of breath, sweating or nausea. The same goes for sudden weakness in the face or arms, trouble speaking or loss of vision. Don't wait to see whether the symptoms go away on their own.