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CVS Pharmacy - Cholesterol Record

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CVS Pharmacy - Cholesterol Record
Know Your Numbers:
What does a cholesterol test measure?
· LDL "bad" Cholesterol--can block blood vessels and lead to heart problems, such as stroke or heart attack
· HDL "good" Cholesterol--helps prevent cholesterol from building up in blood vessels
Triglycerides--another type of cholesterol that can lead to heart problems if too high
Total Cholesterol: __________________________
LDL Cholesterol: ___________________________
HDL Cholesterol: __________________________
Triglycerides: _____________________________
Date of Blood Work
My Goal Cholesterol Levels
Ask your physician to help you fi ll out the information below:
____/____/____ ____/____/____ ____/____/____ ____/____/____ ____/____/____ ____/____/____
Source: Adapted from the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on the Detection, Evaluation, and Treatment of
High Blood Cholesterol in Adults (Adult Treatment Panel III), developed by the National Institutes of Health, NIH Publication No. 01-3670 Revised July 2004
Test Results
< 200 mg/dL
< 100 mg/dL
60 mg/dL
< 150 mg/dL
Initial Results

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