Word On Cholesterol

Our grateful thanks to Professor Liz Hughes from HEART UK (you connect through to the charity via our links page) for her contribution on our radio feature, which you can hear again at the bottom of this page.  

Cholesterol is a fatty, wax-like substance found in your blood. Your body needs some cholesterol to function properly – it’s essential for making hormones, vitamin D and substances that help digest food. However, too much cholesterol in your blood increases your risk of heart disease, heart attack and stroke.

Cholesterol comes from two sources:

• Your liver, which produces most of the cholesterol in your body
• Your diet, particularly foods high in saturated fat such as butter, cheese, pastries, processed meats and fried foods

Because high cholesterol usually causes no symptoms, many people don’t realise their levels are raised until they have a blood test – or worse, until they develop cardiovascular disease.

The different types of cholesterol. You may hear cholesterol described in different ways:

• LDL cholesterol (low-density lipoprotein)
  Often called “bad” cholesterol. High levels can lead to fatty deposits building up in your arteries.
• HDL cholesterol (high-density lipoprotein)
  Known as “good” cholesterol. It helps carry excess cholesterol away from the arteries to be removed by the liver.
• Non-HDL cholesterol
  This is increasingly used by doctors. It represents all the harmful cholesterol in your blood.

Who is at risk of high cholesterol?  Anyone can have high cholesterol, but your risk is higher if you:

• Have a family history of high cholesterol or early heart disease
• Have familial hypercholesterolaemia (FH) – a genetic condition causing very high cholesterol from birth
• Eat a diet high in saturated or trans fats
• Are overweight or inactive
• Smoke
• Have type 2 diabetes, high blood pressure or kidney disease
• Are over the age of 40
• Are from certain ethnic backgrounds where cardiovascular risk is higher

Importantly, even people who appear fit and healthy can have high cholesterol, especially if it runs in their family.

Who should have their cholesterol checked – and when?

• Adults aged 40–74 are usually offered a cholesterol test as part of an NHS Health Check every five years
• You may be tested earlier or more often if you have risk factors such as family history, diabetes, obesity or high blood pressure
• Children and young adults may be tested if familial hypercholesterolaemia is suspected

Your cholesterol can be checked with a simple blood test, either fasting or non-fasting, arranged through your GP or healthcare professional.

What cholesterol levels indicate a problem? Cholesterol is measured in millimoles per litre (mmol/L). General UK guidance for adults is:

• Total cholesterol: ideally below 5 mmol/L
• Non-HDL cholesterol: ideally below 4 mmol/L
• LDL cholesterol: ideally below 3 mmol/L

If you already have heart disease, diabetes, FH, or are at high cardiovascular risk, your doctor will usually recommend much lower targets.

A single result doesn’t tell the whole story – your healthcare professional will assess your cholesterol alongside other risk factors such as age, blood pressure, smoking and family history.

Treatment options for high cholesterol

Lifestyle changes

For many people, the first step is improving heart-healthy habits:

• Reduce saturated fat (fatty meats, butter, cream, pastries)
• Swap to unsaturated fats (olive oil, rapeseed oil, nuts, seeds)
• Eat more fruit, vegetables, wholegrains and pulses
• Include oily fish such as salmon or mackerel twice a week
• Increase physical activity – aim for at least 150 minutes a week
• Maintain a healthy weight
• Stop smoking

These changes can significantly improve cholesterol levels and overall heart health.

Medication

If lifestyle changes aren’t enough – or if your risk is high – medication may be recommended. The most common are:

• Statins, which reduce cholesterol production in the liver
• Other cholesterol-lowering medicines, used alone or in combination for some people

Your treatment plan should always be personalised and discussed with your healthcare professional.

The key message. High cholesterol is common, often silent, but treatable. Knowing your numbers, understanding your risk and taking action – whether through lifestyle changes, medication or both – can dramatically reduce your risk of heart disease and stroke.

For more expert advice and support, visit HEART UK – the UK’s only cholesterol charity - via our links page.

Listen to this weeks radio report