What is High Cholesterol?

Cholesterol is one of the fats present in the body. It is essential for life, and is found in all human and animal tissues. It is carried around the body by the blood. Some cholesterol comes directly from food, and some is made by the liver. High blood cholesterol is usually due to eating too much fat. It can also be caused by not getting enough exercise. Occasionally, high cholesterol runs in the family, and in these circumstances it is due to the body not coping well with normal intakes of cholesterol. The body also makes its own cholesterol. High blood cholesterol can cause health problems. The most important of these is heart disease, including heart attacks. High cholesterol levels cause fatty streaks to build up inside blood vessels. Eventually the vessels can block and blood cannot flow through them. This is particularly likely to happen in the narrow vessels (the coronary arteries) which supply blood to the muscle of the heart itself. This may cause damage to the heart and can cause a heart attack.

Cholesterol Testing

If you have high cholesterol, whatever the cause, it is possible to do something about it. This can reduce your risk of developing heart disease. Your doctor or nurse will take a blood sample to measure your cholesterol level. A desirable level is 5mmol/l or below. Measurements can vary slightly, so it may be necessary to take more than one sample to be certain of the real level. Your doctor might also want to measure the levels of different types of cholesterol in the blood. These are HDL (high density lipoprotein) cholesterol and LDL (low density lipoprotein) cholesterol. They affect how likely it is that a high cholesterol level will lead to heart disease. Knowing about these will help your doctor to assess your risk of heart disease.

Cutting the Risk of a Heart Attack

High cholesterol is only one of several things which can lead to heart disease. Other things include smoking, high blood pressure, stress and lack of physical activity. These are called 'risk' factors because they increase the risk of heart disease. The more risk factors you have, the more likely you are to develop heart disease. To reduce your risk of heart disease, it is important to identify and control as many of your risk factors as possible. High cholesterol is only one of the risk factors to consider Your doctor will be able to assess and advise you on all your risk factors.

There are three main ways to reduce cholesterol levels. The first is to make changes to what you eat. The second is to increase your physical activity. The third is to take medication. For most people, the doctor will recommend trying the first two approaches. This is often enough to get levels down to normal. If this doesn't work, your doctor may add a tablet treatment. You are more likely to receive a tablet treatment if your starting cholesterol level is very high, or if you have a lot of other risk factors, or if you have already had a heart attack.

Lowering Cholesterol by Diet

Making changes in what you eat is the best way to lower your cholesterol level. The main aim is to cut down the amount of fat you eat. However, the type of fat you eat is also important. Saturated fats (such as butter) tend to raise cholesterol. Cutting down saturated fats can lower cholesterol by 20 per cent. Changes in your eating habits have to be long-term to be effective. So you need to find a healthier eating pattern which you are happy with. You can still enjoy your favourite food in moderation, and you don't have to feel guilty about indulging yourself now and then.

• Eat more fish
• Choose low-fat or skimmed-milk dairy products
• Remove all visible fat from meat and skin from chicken
• Choose low-fat cooking methods, such as grilling, steaming or microwaving. Try to avoid fried foods
• Cut down on biscuits, cakes, sweets, crisps and chocolate
• Try to eat at least two servings of fruit and three servings of vegetables every day
• Use unsaturated margarine instead of butter,and unsaturated oils (such as olive oil) instead of lard or dripping
• Limit eggs to two per week
• Choose wholegrain (rather than white) bread, cereals, pasta and rice
• More detailed diet sheet

Lowering Cholesterol by Exercise

Regular exercise can reduce the risk of heart disease from high cholesterol. Exercise also helps other risk factors for heart disease, including high blood pressure, stress and being overweight. The best activity is one that you enjoy. It does not have to be particularly strenuous. Walking, swimming, cycling and gentle jogging are all effective. Try to take regular, moderate exercise, preferably every day. If possible, make it part of your daily routine. For example, walk short distances rather than take the bus or the car, or walk up stairs instead of using the lift. The more you do, the better, but any exercise beats none at all. If you are not fit, start gradually and build up your activity level over several weeks. Vigorous exercise can occasionally be dangerous. If you plan to do vigorous exercise, it is wise to see your doctor first if you:

• have known or suspected heart disease
• smoke heavily
• are very overweight
• have not been physically active recently.

Lowering Cholesterol by Medication

Medication can be an effective way of lowering even very high cholesterol levels. If medication is required, it usually needs to be taken long-term. Your doctor will advise you whether or not you should consider taking medication.

For Further Information about Cholesterol and Heart Disease Risk

• for men click here
• for women click here