High Cholesterol

What is High Cholesterol?

Cholesterol is a fatty substance carried around the body by proteins. When cholesterol and proteins are combined, they are called lipoproteins. Your Cholesterol is measured it units called millimols per litre of blood (mmol/l). There are two main types of lipoproteins:

• Low Density Lipoproteins (LDL) - This is known as the bad type of cholesterol. LDL carries cholesterol from your liver to the cells that need it.

• High Density Lipoproteins (HDL) - This is known as the good type of cholesterol. HDL carries cholesterol away from the cells and back to the liver to be broken down. Too much bad cholesterol (LDL) in your blood can cause fatty material to build up in your artery walls. The risk is particularly high if you have a high level of bad cholesterol and a low level of good cholesterol. If you have a high level of Low Density Lipoproteins (LDL) bad cholesterol and a low level of High Density Lipoproteins (HDL) good cholesterol then you are more likely to get high cholesterol.

General Recommendations for Total Levels of CholesterolRecommended Low Density Lipoprotein (LDL)
5mmol/L or less for healthy adults 3mmol/L or less for healthy adults
4mmol/L or less for those considered at high risk 2mmol/L or less for those at high risk

What are triglycerides?

Triglycerides are another type of fatty substance in the blood. Like LDL (bad cholesterol) these are also bad. They’re found in foods such as dairy products, meat and cooking oils. They can also be produced in the body, either by the body’s fat stores or in the liver. Your triglyceride levels should be less than 1.7 mmol/l.

Triglycerides are the main form of fat in the body. When you think of fat developing and being stored in your hips or belly, you're thinking of triglycerides. Consider these things: The fat we eat exists in relatively huge molecules inside food. Triglycerides are the end product of digesting and breaking down these bulky fats. Any extra food we eat that's not used for activity right away - carbohydrates, fat, or protein - is also chemically converted into triglycerides. Triglycerides are then bundled together into globules. These are transported through the blood. Proteins (called lipoproteins) help transport these triglyceride blobs. The triglycerides are taken up by adipose (fat) cells to be used for energy if food isn't available later- or during your next diet. Triglycerides are measured using a common test called a lipid profile. It's the same blood test that checks "good" and "bad" cholesterol levels. In the UK the NHS has recommended that people aged 40-74 have a vascular health check, which will include a lipid profile. 

What are the risk factors of High Cholesterol?

• Poor diet- Eating too much fatty foods (saturated fat) and too many foods that are high in cholesterol raises your cholesterol levels.

• Smoking- A chemical in cigarettes called acrolein stops good cholesterol (HDL) transporting cholesterol from fatty deposits to the liver, leading to narrowing of the arteries.

• Lack of exercise and physical activity- This increases your level of bad cholesterol (LDL).

• High alcohol intake- Regularly drinking large amounts of alcohol can increase your triglyceride levels.

• Inheritance- If you have a family history of high cholesterol then you are more likely to develop it as you get older.

• Obesity- If you are overweight or obese it is more likely that you will have higher levels of Low Density Lipoprotein (LDL) cholesterol and triglycerides, and a lower level of High Density Lipoprotein (HDL).

• Diabetes

• Age- as you get older the risk increases

• High Blood Pressure

• Gender

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What are the health risks associated with High Cholesterol?

Evidence strongly indicates that high cholesterol can increase the risk of:

  • narrowing of the arteries (atherosclerosis) 
  • heart attack 
  • stroke 
  • transient ischaemic attack (TIA) – often known as a "mini stroke"
  • peripheral arterial disease (PAD)
  • Complications such as Kidney or Liver Disease

This is because cholesterol can build up in the artery wall, restricting the blood flow to your heart, brain and the rest of your body. It also increases the risk of a blood clot developing somewhere in your body.

Your risk of developing coronary heart disease also rises as your blood's cholesterol level increases. This can cause pain in your chest or arm during stress or physical activity (angina).

When should my cholesterol levels be tested?

Your GP may recommend that you have your blood cholesterol levels tested if you:

  • have been diagnosed with coronary heart disease, stroke or mini stroke (TIA), or peripheral arterial disease (PAD)
  • have a family history of early cardiovascular disease
  • have a close family member who has a cholesterol-related condition
  • are overweight
  • have high blood pressure, diabetes, or a health condition that can increase cholesterol levels 

What counts as normal cholesterol levels?

Blood cholesterol is measured in units called millimoles per litre of blood, often shortened to mmol/L.

As a general guide, total cholesterol levels should be:

  • 5mmol/L or less for healthy adults
  • 4mmol/L or less for those at high risk

As a general guide, LDL levels should be:

  • 3mmol/L or less for healthy adults
  • 2mmol/L or less for those at high risk

An ideal level of HDL is above 1mmol/L. A lower level of HDL can increase your risk of heart disease.

Your ratio of total cholesterol to HDL may also be calculated. This is your total cholesterol level divided by your HDL level. Generally, this ratio should be below four, as a higher ratio increases your risk of heart disease.

However, cholesterol is only one risk factor and the level at which specific treatment is required will depend on whether other risk factors, such as smoking and high blood pressure, are also present.

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How can High Cholesterol be managed? 

• Having regular cholesterol tests will give you a clear understanding of your cholesterol levels.

• Symptoms are practically non-existent unless a serious incident such as a heart attack or stroke occurs.

• Eat a healthy balanced diet- More fruits, vegetables, whole grains, fish, low fat or non-dairy foods

• Do regular exercise

• Quit smoking

• Losing weight if you are obese or overweight