Conditions
High cholesterol: what your results mean and how we treat it by video
High cholesterol almost never causes symptoms: it is found with a blood test called a lipid panel. By video, the doctor goes over your results with you, explains your heart risk, gives you a lab order for your next panel and, if appropriate, prescribes and we send your prescription to your pharmacy. Refills of a medicine you already take are US$49.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Chest pain, pressure or tightness, especially if it spreads to the arm, jaw or back
- Sudden shortness of breath
- Weakness or numbness on one side of the body, a drooping face or trouble speaking
- Sudden loss of vision, or severe dizziness with trouble walking
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At a glance
High cholesterol
Common symptoms
- Usually no symptoms
- Chest pain once complications develop
- Other names
- Hypercholesterolemia · Dyslipidemia
- Usual test
- Lipid panel (total cholesterol, LDL, HDL and triglycerides)
- Treatment
- Changes in eating and activity; statins or other medicines when the medical evaluation indicates them
- Possible complication
- Heart attack and stroke from plaque building up in the arteries
On this page(10)
What high cholesterol is
Cholesterol is a fat your body needs, but when LDL (the "bad" cholesterol) is high, plaque builds up in your arteries. That plaque narrows blood flow and, over time, can cause a heart attack or a stroke.
Having high blood pressure or type 2 diabetes as well raises the risk, so it makes sense to follow them up together.
High cholesterol treatment by video
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you. You see Dr. Diana Nieves Castro, MD, a general practice physician licensed in Puerto Rico (check her license) with several years of emergency-department experience, in English or Spanish. And if you want someone to follow you all year, she can be your online primary care doctor.
In your visit, the doctor reviews your results, looks at your LDL together with your age, blood pressure, smoking, diabetes and family history, and agrees the right goal with you. She gives you a lab order for your next lipid panel and adjusts your plan. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. It is part of our chronic care, with clear prices, no membership, and run by a nonprofit.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
How to book your visit in 3 steps
Booking a cholesterol visit is simple:
Request your visit.
Request a visit online 24/7 — we confirm your time by email or text. Choose Doctor visit, or Follow-up visit if you only need a refill of a medicine you already take, and pay by card at secure checkout. Book your visit.
Get your link.
We send you a secure video link. It works on your phone, tablet or computer. You need to be in Puerto Rico during the visit (visitors are welcome). Patients under 21 need a parent or legal guardian on camera with photo ID.
See the doctor.
The doctor evaluates, diagnoses and treats you. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If you need a test, we give you a lab order for a lab near you.
Price: a US$79 doctor visit, no membership
A doctor visit costs US$79, the same price for every age, with no membership and no insurance needed. You are charged when you request the visit, and you get a full refund if the visit can't happen. The lab order is part of the visit; the lab charges for the tests and the pharmacy for the medicine. A doctor's note after your visit is included at no extra charge. See all prices.
If you only need a refill of the cholesterol medicine you already take, choose the US$49 follow-up visit; anyone can book it. A review of lab results is also a US$49 follow-up visit, for existing patients. If a US$49 visit turns out to need a full visit, the doctor explains why and, with your consent, you pay the difference.
Video visit
Doctor visit
US$79
For a new problem, urgent care (non-emergencies), primary care, children, birth control, STIs, skin and acne, and visitors. Includes a doctor's note if you need one.
- You’re charged when you request the visit.
- Full refund if the visit can’t take place
High cholesterol symptoms: why you cannot feel it
High cholesterol usually causes no symptoms. Plaque builds up in the arteries silently until it narrows blood flow, and then it can cause chest pain once complications develop, a heart attack or a stroke. That is why it is checked with regular tests even when you feel fine.
Treatment and when a lab test is ordered
A lipid panel is a blood test that measures several fats. These are the healthy values for adults 20 and older, according to MedlinePlus (NIH):
- Total cholesterol: less than 200 mg/dL.
- LDL, the "bad" cholesterol: less than 100 mg/dL.
- HDL, the "good" cholesterol: higher is better; 60 mg/dL or more is best.
- Non-HDL cholesterol: less than 130 mg/dL.
- Triglycerides: another blood fat; high levels may raise your risk of heart disease.
The doctor gives you a lab order on these general MedlinePlus intervals, or more often if you already have high cholesterol or take medication: adults 20 and older without other risks, every 5 years; men 45 to 65 and women 55 to 65, every 1 to 2 years; over 65, every year. You may be asked to fast for 9 to 12 hours before the test.
Eating less cholesterol and saturated fat, being more active, keeping a healthy weight and not smoking all help lower cholesterol and heart risk. When medication is needed, treatment may include a statin, the most commonly used group; other groups exist for specific situations.
High triglycerides
Triglycerides are another blood fat measured in the lipid panel. According to MedlinePlus, in adults they are healthy below 150 mg/dL, borderline high at 150 to 199, high at 200 to 499 and very high at 500 or more. Very high levels greatly raise the risk of acute pancreatitis.
They go up with foods high in fat, sugar and refined carbohydrates, inactivity, poor sleep, heavy drinking, excess weight and uncontrolled diabetes. The test sometimes requires 9 to 12 hours of fasting; follow the instructions you are given. The doctor reviews your results with you by video and explains what to change and whether treatment is needed.
Cholesterol in children
We see adults and children of all ages. MedlinePlus says children should have a first cholesterol test between ages 9 and 11, repeated every 5 years. If your family has very high cholesterol or early heart disease, the doctor can give you a lab order for your child sooner.
When to go to the ER
For your safety, call 911 or go to the emergency room if you have any of these signs. See also when to go to the ER.
- Chest pain, pressure or tightness, especially if it spreads to the arm, jaw or back
- Sudden shortness of breath
- Weakness or numbness on one side of the body, a drooping face or trouble speaking
- Sudden loss of vision, or severe dizziness with trouble walking
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
What cholesterol level is dangerous?
Does high cholesterol cause symptoms?
Do I need to fast before the test?
Can I get my cholesterol medicine refilled by video?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-09-30 · Updated: 2026-10-02
Sources (4)
- MedlinePlus (NIH): Cholesterol levels (opens in a new tab) (accessed 2026-09-30)
- CDC: About cholesterol (opens in a new tab) (accessed 2026-09-30)
- NIDDK (NIH): Managing diabetes, including cholesterol (opens in a new tab) (accessed 2026-09-30)
- Triglycerides test (MedlinePlus) (opens in a new tab) (accessed 2026-10-02)