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High cholesterol

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read
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Cholesterol is a fatty substance that is present in your blood. High cholesterol, also known as hypercholesterolemia, occurs when there are raised levels in your body.

Fatty substances build up in your blood mainly as a result of diet and lifestyle choices. Eating unhealthy fatty foods and not exercising enough puts you at risk of developing high cholesterol. If you smoke or drink alcohol or are overweight, your risk increases further. Too much cholesterol can cause a blockage in the blood vessels. There is a link between the increasing blockage of blood vessels and a higher risk of a heart attack or stroke.

If someone in your family has high cholesterol, you are more likely to suffer from it. There are no symptoms of high cholesterol. The only way to confirm this is with a blood test.

When should I get a cholesterol blood test?

If you are overweight, have a poor diet, or are over 40 years old and have never had the test, it is recommended to have your cholesterol levels checked. If anyone in your family has suffered from high cholesterol or heart problems, it is also recommended to get testing.

What will my doctor do?

The doctor will likely order your cholesterol blood test alongside a few other routine blood tests. Your doctor may take your blood pressure, calculate your BMI score and take into account your demographics; this will allow them to calculate your risk of developing cardiovascular disease (CVD) in the next 10 years (CVD risk score).

If your cholesterol level is raised, your CVD risk score is above 10%, or you are not improving your levels with lifestyle changes alone, your doctor may recommend a cholesterol-lowering medication.

Statins are common medications that reduce the amount of cholesterol in your body. These medications are often well tolerated, but in some, they can cause muscular aches and pains and affect your liver. Your doctor will guide you on how to start this medication appropriately.

How to interpret the blood test?

There are usually 4 different measures for the cholesterol level. Total cholesterol is the overall amount of cholesterol in your blood. This should be 200 or below. HDL (good cholesterol)- this reduces your risk of a heart attack or stroke. This should be 60 or above. LDL (bad cholesterol)- this increases your risk of heart problems or stroke and should be 100 or below. Triglycerides are similar to bad cholesterol and should be 150 or below.

Optimizing your cholesterol blood results reduces your risk of developing heart attacks or stroke.

How to lower your cholesterol?

If your cholesterol level is raised, the first and most important step is to address your diet. It is important to reduce the amount of microwaveable, junk, processed, and take-out foods you consume. It is important to increase your good fats and nutrient-dense healthy foods; for example, nuts and seeds, fruit and vegetables, and oily fish like mackerel. It is advised to switch your dietary intake of pasta, rice, and bread to whole-grain varieties.

It is also advised to exercise regularly; 150 minutes of moderate exercise or 75 minutes of intense activity a week. If you smoke or drink alcohol, it is recommended to stop smoking and drink less than 14 units of alcohol a week to reduce your risk.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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