High Cholesterol
Management of abnormal cholesterol levels through lifestyle measures and medication when appropriate
What is high cholesterol?
Cholesterol is carried in the blood by particles, and it is the LDL particles that deposit it in artery walls. A high level does not make you feel unwell; it raises the chance of a heart attack or a stroke years later.
Diet and weight matter, and so does inheritance. Familial hypercholesterolaemia raises the level from birth and runs in families, and it is the reason a very high reading in a younger person prompts testing of relatives.
What you might notice
- A cholesterol report with values out of range
How it is diagnosed
A lipid profile measures total cholesterol, LDL, HDL and triglycerides. Fasting is no longer needed for most of it.
The number on its own does not decide treatment. Your doctor calculates your overall cardiovascular risk from age, blood pressure, smoking, diabetes and family history, and the target and the decision to treat follow from that calculation instead of from the LDL figure alone. Thyroid, kidney and liver function are checked, since each can raise lipids.
Recovery
Lipids fall within four to six weeks of starting a statin, and the profile and liver function are rechecked at that point.
Muscle aches are the side effect people ask about most. They are less common than reputation suggests, and where they do occur a change of drug or dose usually resolves them, so it is worth reporting instead of stopping.
If it is left untreated
Cholesterol deposited in an artery wall forms a plaque, which narrows the artery and, more importantly, can rupture and trigger a clot. That is the mechanism of most heart attacks.
Because this takes decades and produces no symptoms, the first indication is frequently the heart attack itself. Lowering the level does not undo existing plaque, but it measurably reduces the chance of that event.
Questions about high cholesterol
Is diet enough?
It depends on your overall risk and how far the level has to fall. Diet and weight loss typically move LDL by a modest amount, which is sufficient for some people and not for those at higher risk.
Do statins cause muscle pain?
Muscle aches are reported, and in trials where neither patient nor doctor knew who was taking the statin the difference was small. Where they do occur, a change of drug or dose usually resolves it, so report it instead of stopping.
Why does my target differ from someone else's?
Because the target is set from overall cardiovascular risk instead of from the cholesterol figure alone. Someone who has already had a heart attack or has diabetes is treated to a lower level than someone at low risk with the same reading.
Other general medicine treatments
One doctor for the whole family, for everyday illness, long-term conditions, check-ups and referral to the right specialist
Day CareDiagnosis and long-term medical management of diabetes, including blood sugar, lifestyle and complication monitoring
Day CareTalk to a care coordinator about high cholesterol
Leave a number and a care coordinator calls you back with what the treatment involves and which hospital it would be at. They book a consult only if you want one