Cholesterol advice

What does it mean to have high cholesterol?

Cholesterol is a fatty substance known as a lipid and is vital for the normal functioning of the body. It is mainly made by the liver but can also be found in some foods we eat.

Evidence strongly indicates that high cholesterol can increase the risk of:
• narrowing of the arteries (atherosclerosis)
• heart attack
• stroke
• mini-stroke (A transient ischaemic attack - TIA)

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

Your risk of coronary heart disease (when your heart's blood supply is blocked or disrupted) also rises as your blood's cholesterol level increases and this can cause angina during physical activity.

There are many factors that can increase your chance of having heart problems or stroke if you have high cholesterol, including the following:
• an unhealthy diet: some foods already contain cholesterol (known as dietary cholesterol) but it is the amount of saturated fat in your diet which is more important
• smoking: a chemical found in cigarettes called acrolein stops HDL from transporting LDL to the liver, leading to narrowing of the arteries (atherosclerosis)
• having diabetes or high blood pressure (hypertension)
• having a family history of stroke or heart disease

There is also an inherited condition known as familial hypercholesterolaemia (FH). This can cause high cholesterol even in someone who eats healthily.

When should I test my cholesterol levels? 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)
• are over 40
• have a family history of early cardiovascular disease
• have a close family member has a cholesterol-related condition
• are overweight
• have high blood pressure, diabetes or a health condition that can increase cholesterol levels, such as an underactive thyroid

How can I lower my cholesterol levels?

The first step in reducing cholesterol is to maintain a healthy, balanced diet. It is important to keep your diet low in fatty food, especially food containing saturated fat, and eat lots of fruit, vegetables and wholegrain cereals. This will also help to prevent high cholesterol from returning.

• Eat more fibre.
• Whole grains, fruit and vegetables improve the fibre in the diet and reduce the absorption of fats from the gut.
• Food products containing plant sterols lower cholesterol.
• Use olive oil containing products instead of those high in animal fats.
• Chooses low fat foods and low fat cooking techniques.

Other lifestyle changes can also make a big difference. It will help to lower your cholesterol if you do regular exercise and quit smoking.  Read more information on quitting see our smoking section.

If these measures are not helping to reduce your cholesterol and you continue to be at a high risk of heart disease, your GP may prescribe a cholesterol-lowering medication such as statins.

What do statins do?

All statins lower the fat (cholesterol) in the blood by acting on the liver in a way which stops it making cholesterol to as high a level.

As statins lower the cholesterol they work by;
• Reducing the formation of plaques in the lining of the vessel walls.
• Reducing the size of plaques and making them less likely to rupture.
• There is evidence that lowering cholesterol with statins actually reverses the narrowing of blood vessels and can improve angina symptoms.

For more advice please visit the British Heart Foundation (BHF) website or telephone the BHF Heart Helpline on 0300 330 3311.

Page last updated:04 February 2013