Cholesterol, Total

The Cholesterol, Total test (blood cholesterol, total chol) is used to gauge cardiovascular risk, to screen individuals without symptoms as part of lipid profiling, and to follow the response to dietary change and lipid‑lowering therapy. Clinicians commonly pair total cholesterol with other lipid measures for a more complete assessment of dyslipidemia and treatment effect.

Cholesterol is a fundamental component of cellular membranes and serves as the precursor for steroid hormones and bile acids. Because it is not water soluble, it circulates bound within lipoproteins that differ by density and composition, primarily very‑low‑density lipoproteins (VLDL), low‑density lipoproteins (LDL), and high‑density lipoproteins (HDL). LDL‑C and VLDL‑C are considered atherogenic, whereas HDL‑C participates in reverse cholesterol transport. Total cholesterol represents the cumulative cholesterol content across all lipoprotein classes. Most circulating cholesterol is synthesized by the liver, with additional contributions from dietary intake, notably from meat and full‑fat dairy products. When genetic susceptibility and/or excessive dietary intake are present, plasma cholesterol can increase, fostering atherosclerotic plaque development, vascular stiffening, and greater risk of ischemic heart disease and stroke.