All the high cholesterol information you need for living well

You may be wondering, what is high cholesterol? Below, we explore what causes high cholesterol, what the symptoms of high cholesterol are, and what treatments for high cholesterol are available.

Any high cholesterol information provided here is for informational purposes and does not replace medical advice given to you by a medical professional. If you are concerned that you may have any of the high cholesterol symptoms discussed below, please see your GP.

What is high cholesterol?

Our bodies need a substance called cholesterol to function, and cholesterol has important roles within the body. Made in the liver, cholesterol forms the membrane of our cells. It is needed to produce vitamin D and hormones that keep us healthy and it also helps digest fats in food by making bile. Cholesterol is found in some of the foods we eat, as well as produced naturally by the body.

If we have too much cholesterol in our bodies, this can cause problems and may lead to the development of several serious health conditions such as stroke, coronary heart disease, heart attack, atherosclerosis or other cardiovascular conditions. Proteins carry cholesterol around the body in the bloodstream and there are two types:

• High density lipoprotein (HDL) –  “good” type of cholesterol as it is easily removed as a waste product when it isn’t needed by the body.
• Low density lipoprotein (LDL). The “bad” type of cholesterol, which can build up inside arteries if there is more in the body than is required.

It is the build-up of LDL within the arteries that leads to atherosclerosis and an increased risk of strokes, heart problems and other cardiovascular disease.

There are no high cholesterol symptoms that a person may be able to detect, and a high cholesterol diagnosis is only possible by having a test via a GP. It’s important to ensure you do not have high cholesterol, to avoid other health conditions that may occur as a result.

For more high cholesterol information, visit Heart UK.

What causes high cholesterol?

These four factors are what causes high cholesterol:

Too much saturated fat in your diet

Found in processed foods, full fat dairy and meats. Read more information on saturated fats.

Not being active enough or doing enough exercise

This means fats in the diet are not being used up and are, instead, stored by the body.

Smoking

Chemicals in cigarettes can stop the process of high density lipoproteins removing unused cholesterol from the body as waste, which can lead to atherosclerosis.

Familial hypercholesterolaemia

A genetic condition that means a person has high cholesterol even from birth, and by their 20s or 30s may be at risk of heart attack or stroke. Read more information about familial hypercholesterolaemia.

Did you know?

High cholesterol can lead to serious health conditions such as heart attacks, strokes and heart disease if left untreated.

What are the symptoms of high cholesterol?

There are no symptoms of high cholesterol, which makes it impossible to know whether or not you have it. There are no high cholesterol signs to be aware of, and people of varied ages, shapes and sizes may have high cholesterol. It is a myth that only overweight people have high cholesterol, and high cholesterol levels do not relate to body fat.

While there are no high cholesterol symptoms, it’s important to get your cholesterol levels checked, and to try to eat healthily and get regular exercise to keep cholesterol levels low.

Some people with consistently high cholesterol may go on to have a heart attack or develop heart disease. This is because bad cholesterol clogs and damages the interior walls of the arteries and may cause atherosclerosis. This can lead to heart failure due to the heart being put under more pressure and becoming less functional over time. Heart attacks occur when the blood supply in an artery is blocked. For more information on how high cholesterol and atherosclerosis affect the heart, visit British Heart Foundation.

High cholesterol can also lead to strokes, again due to arteries becoming damaged or blocked. Read more about stroke and high cholesterol risks. Read more about stroke and high cholesterol risks at the  Stroke Association charity.

Diagnosis of high cholesterol

Since there are no high cholesterol symptoms, it is good to know your cholesterol levels by getting them checked. There are home testing kits available, but these are not proven to be as effective as having a test at your GP surgery or pharmacy, so these are usually the best option. It’s important to have cholesterol checked at age 40 and then regularly onwards. If you have a family history of high cholesterol, you should tell your GP and have regular checks, probably from an earlier age.

Cholesterol is tested via a blood test and this measures both low density lipoprotein and high density lipoprotein levels. Cholesterol is measured in millimoles per litre of blood, so your result will read in units mmol/L. You may also have levels of triglycerides tested at the same time as cholesterol – this is another fat used in the body. Read more information on how a diagnosis of high cholesterol is made.

If you are given a high cholesterol diagnosis by a healthcare professional, you may need to make lifestyle changes to reduce your cholesterol and will need to monitor your dietary cholesterol.

Read more information on high cholesterol symptoms and high cholesterol diagnosis.

Did you know?

Some people are more at risk of having high cholesterol than others, depending on their age, genes and other health conditions.

Treatments for high cholesterol

It is possible to lower cholesterol to acceptable levels by following a healthy diet for high cholesterol, increasing activity levels and possibly taking high cholesterol medications.

The high cholesterol treatment plan proposed to you by your GP, nurse or pharmacist may include tips on how to eat healthily and switch to a low cholesterol diet, as well as how much exercise you should try to get each day. This section of the guide focuses on medication treatments for high cholesterol.

How is high cholesterol treated?

There are several different types of drug medications used as high cholesterol treatments, such as:

Statins

This type of drug reduces cholesterol in the bloodstream by stopping the liver from making so much cholesterol. They help people who are at risk of heart disease and often need to be taken for life. Examples include atorvastatin and simvastatin. People with familial hypercholesterolaemia often have to take statins. Learn more about statins.

Aspirin

Low doses of aspirin help reduce the risk of blood clots developing, which can cause heart attacks and strokes.

Ezetimibe

This stops cholesterol from being absorbed into the blood and has fewer side effects than statins. Learn more about ezetimibe.

Bile acid sequestrants (resins)

Used when other medications do not work, bile acid sequestrants stop the body from re-absorbing bile acids, which in turn lowers cholesterol levels because one function of cholesterol is to make bile.

Fibrates

This high cholesterol treatment works by slowing the cholesterol build up in arteries to reduce the risk of heart attacks, heart disease and strokes.

PCSK9 inhibitors

These are new drug treatments for high cholesterol and work by stopping the PCSK9 protein from being made in the liver. Usually prescribed if you have very high levels of cholesterol, or have already had a heart attack or stroke, and traditional medications are not working well enough. Read more about PCSK9 inhibitors.

LDL-apheresis

Similar to dialysis, this process filters blood through a machine to remove cholesterol and then puts it back in the body, and is usually used for people with familial hypercholesterolaemia, or who have very high cholesterol where other high cholesterol treatments are not working. Read more about LDL-apheresis.

Did you know?

There are no symptoms of high cholesterol, so it’s advisable to have a cholesterol blood test regularly, especially if you are over 40 years old.

Living with high cholesterol

Receiving a high cholesterol diagnosis may be a shock to you because there are no high cholesterol symptoms that you will have noticed, and you may feel fit and healthy. You may wish to look at this as an opportunity to make some lifestyle changes to help you live healthier.

Next, we explore what living with high cholesterol may be like and how it may impact your life. We also cover the lifestyle changes, such as diet for high cholesterol and exercise for high cholesterol, that you may need to make.

Impact on daily living

Having a high cholesterol diagnosis may affect your day-to-day life depending on the severity of your condition and how much it is impacting your health. If a person is considered to be at risk of heart attack or stroke, or has perhaps already experienced one of these conditions as a result of high cholesterol, they may have to make drastic lifestyle changes to ensure they lower their cholesterol. Even those with slightly raised cholesterol will be advised to try and lower it by changing their diet, increasing their activity levels and making other lifestyle changes.

You may be advised to:

Eat more healthily

Following a diet for high cholesterol is really important, because saturated fat in foods we eat raises the body’s cholesterol levels. Cholesterol itself is contained in foods we eat but, generally, people are advised that high cholesterol foods do not make a big difference to blood cholesterol levels. Eating a balanced, varied and healthy diet is more important. There are lots of cholesterol-lowering foods that can help with the condition.

Increase your exercise/activity levels

Exercise lowers levels of bad LDL cholesterol and increases good HDL cholesterol, so it helps keep the arteries and the heart healthy, as well as reducing the risk of other health conditions.

You may be interested in exercise aids for high cholesterol which can help you start a home exercise programme – these products are safe and comfortable to use, even for beginners. For example, pedal exercisers, dumbbells and resistance bands are useful aids for people of all experience levels.

Quit smoking

Cigarettes, cigars, tobacco and shisha all contain chemicals that harm the body, making bad LDL cholesterol stick to the artery walls and lowering good HDL cholesterol levels. There is lots of support and help for quitting smoking. Read more about why smoking affects cholesterol levels. For advice on quitting smoking, visit Smoke Free.

Cut down on alcohol

Alcohol turns into triglycerides and cholesterol in the liver, which raises levels of these and causes liver function to decrease, resulting in the liver being unable to remove cholesterol from the body. Read more about how to cut down your alcohol intake, or stop drinking altogether, at Drink Aware.

It may help you to read stories from other people living with high cholesterol.

Diet for high cholesterol

Foods to avoid

Eating a healthy, balanced diet is important if you have a high cholesterol diagnosis, and this may help to prevent high cholesterol in the first place.

Reducing your consumption of saturated fats is important, which is likely to be found in these foods:

• Biscuits, baked goods and cakes

• Chocolate

• Processed meats such as sausages and bacon

• Full fat dairy like cheese, milk, cream, yoghurt

• Animal fats including butter, ghee, lard, suet, dripping

• Fatty types of meat such as lamb, beef, duck and pork

• Other oils, like coconut oil and palm oil.

This is because saturated fat can raise blood cholesterol and make the liver less able to remove cholesterol from the body. Read about how to eat less saturated fat.

Some foods are naturally high in cholesterol, such as eggs, offal and certain types of seafood, but it’s unlikely you need to cut down on these as it will make little or no difference to your overall blood cholesterol.

Good food choices

Some foods actually help reduce the amount of blood cholesterol, including:

• Soya-based foods such as soya milk, edamame beans, soya sausages, Quorn

• Nuts

• Oats

• Sterol and stanol foods such as Benecol yoghurts and spreads

• Fruit

• Vegetables

• Oily fish

• Avocado

• Vegetable oils, such as olive oil and rapeseed oil

• Seeds, such as sunflower seeds and pumpkin seeds

• High fibre foods, including wholemeal bread and cereals, pulses, skin-on potatoes.

Read more about cholesterol-lowering foods.

There are lots of foods that are high in unsaturated fat, which is a better type of fat for the body, such as oily fish, nuts and avocados. Read more about fats in foods.

Some people take vitamins and minerals as supplements for high cholesterol, such as omega 3, plant sterols and garlic. You should always check with your GP or nurse before taking high cholesterol supplements.

It is possible to reduce your blood cholesterol levels through subtle dietary changes. Watch this personal story about how lifestyle changes can lower cholesterol.

Read general healthy eating advice at NHS Change4Life.

Exercise for high cholesterol

Regular physical activity is really important to a person’s overall health and wellbeing, especially if they have high cholesterol. Exercise increases the amount of good HDL cholesterol and decreases the amount of bad LDL cholesterol. Being physically active also helps lower blood pressure and helps reduce the risk of heart problems, stroke and diabetes.

There are lots of ways to get active – you don’t have to join a gym. Adults should try to achieve 150 minutes of exercise per week.

Read more information and advice about increasing your exercise levels.

High cholesterol and employment

High cholesterol is rarely a barrier to employment, but you may wish to explain your high cholesterol diagnosis to your employer. You may need to take time off occasionally for medical appointments to have your cholesterol checked or you may have side effects from medication that make your working day difficult. Many people with high cholesterol work as normal and make recommended lifestyle changes to help reduce cholesterol levels.

Did you know?

Eating too much saturated fat, smoking, drinking alcohol, and getting little or no exercise can lead to high cholesterol.

Where can I find further high cholesterol information and support?

We hope the high cholesterol information provided here has been helpful. High cholesterol can usually be treated effectively so that you can live well and avoid future health risks.

There is a lot of high cholesterol help available to you. This section lists lots of sources for high cholesterol support and information. We also include links to other online resources with information and advice. If you are concerned about anything you have read in this guide, please discuss it with your GP.

If you would like to speak to one of our Occupational Therapists to see if there are any living aids in our collection that may help you or someone you care for, please contact us. The experienced team will be able to talk to you about your needs and will find the ideal high cholesterol aids to help you.

PLEASE NOTE: Our Expert Advice Service can only advise about equipment and products which may help you to live more independently. They cannot give any advice on medications or treatments for symptoms of this condition.

Communities

High Blood Pressure and High Cholesterol Help – a Facebook group for people with high cholesterol to share tips, advice, information and personal experiences.

Resources

British Heart Foundation – a charity supporting people with heart problems and related conditions such as high cholesterol and atherosclerosis, featuring online high cholesterol information, leaflets, and a heart helpline.

Heart UK – a charity providing support, information and education to families with raised cholesterol, including a helpline, factsheets and real life stories.

Kidney Patients UK – a charity supporting people with kidney conditions, which also features information and advice about high cholesterol, and its link to kidney health.

NHS – source of official medical information about causes, symptoms and treatments for high cholesterol and related conditions.

Stroke Association – information and advice about high cholesterol and how it may cause stroke.

Did you know?

There are drug treatments for high cholesterol, and eating a healthy diet and becoming more active can help lower cholesterol effectively.

Glossary

Although we always try to explain things as simply and as clearly as possible, sometimes it’s necessary to use the correct medical terminology. Medical terms are often known for being tricky to pronounce and if you’re not an expert in the subject, they can also be a little difficult to understand. Below, we’ve put together a list of terms used on this page along with a brief explanation of what they mean to help make your understanding of high cholesterol as straightforward as possible.

Arteries

Tubes in the body that carry blood.

Atherosclerosis

A condition where plaque builds up in the arteries, causing them to narrow, which may lead to heart disease and other health conditions.

Bile

Fluid found in the body which aids digestion and is released by the liver.

Cardiovascular disease

A group of conditions affecting the heart and blood vessels, such as heart disease, heart attack, atherosclerosis or angina.

Cells

The building blocks of life, which give the body structure and carry out essential functions such as converting nutrients into energy within the body

Cholesterol

​​Found in the body’s cells, this waxy substance can build up in the body, for instance in the arteries, which can lead to heart disease.

Dialysis

Medical process of removing waste products or fluid from the blood.

Heart attack

Block of blood supply to the heart.

Membrane

A protective coating that acts as a barrier; in the case of cells, it allows in some particles and denies access to others that could be harmful.

Omega 3

Occurs naturally in foods such as fish, this is important for brain and heart health.

Proteins

In the blood, proteins transport hormones, vitamins and other components around the body.

Saturated fat

A type of fat that causes high cholesterol

Statins

Drugs that can lower levels of bad cholesterol in the blood

Sterols and stanols

Substances in plants that help block cholesterol from being absorbed in the body, which is added to some brands of foods such as spreads and yoghurts to help lower cholesterol levels.

Triglycerides

Fat stored in the body in fat cells, which is released later when energy is required in between meals.

Vitamin D

Essential vitamin used by the body that helps bone growth and maintenance.