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Strong Women
Everything a GP wants you to know about high cholesterol – including how to do something about it
By Lauren Geall
10 months ago
6 min read
Just how concerned do we need to be about our cholesterol? A GP sets the record straight…
We all know high cholesterol can spell bad news for our health, but it’s typically seen as an issue that affects people in their 60s or 70s. While cholesterol levels increase with age, it’s also true that you could develop high cholesterol (and therefore a higher risk of heart attack or stroke) at any age.
The good news is that making a few simple lifestyle changes can have a positive impact on your cholesterol levels, and that some forms of cholesterol are beneficial for our health and wellbeing. The key to living a cholesterol-friendly lifestyle is understanding the difference between the ‘good’ and ‘bad’ types of cholesterol, as well as the steps you can take to keep things under control.
So, to help you wrap your head around all thing’s cholesterol, we asked Dr Unnati Desai, national GP lead at Nuffield Health, to answer some of our burning questions. From the risk factors associated with high cholesterol to what it takes to reduce cholesterol levels, here’s what she had to say.
What is cholesterol?
First things first, what exactly are we talking about when we reference ‘cholesterol’? “Cholesterol is a fatty substance that is present in the blood,” Dr Desai explains. “It’s produced in the liver, but we also get it from food – in the modern world, our diet is the number one cause of high cholesterol.”
There are two main types of cholesterol: low-density lipoprotein, or LDL, and high-density lipoprotein, or HDL. HDL is what we commonly call ‘good’ cholesterol, because it helps to keep our artery walls clear by absorbing cholesterol in the blood and carrying it back to the liver, where it can be flushed from the body. LDL, on the other hand, is what we know as ‘bad’ cholesterol. It transports fats and cholesterol to our tissues and then deposits them on the lining of the arterial walls, where they form plaque. This is bad news, because plaque restricts blood flow.
“This increases our risk of developing high blood pressure, heart disease and stroke,” Dr Desai adds. “The higher the level of your LDL, the more plaque build-up occurs.”
The plaque build-up triggered by high LDL levels is bad news because it sits within the lining of the arteries, also known as the endothelium. It’s for this reason that plaque build-up can restrict blood flow: the endothelium is responsible for producing and releasing nitric oxide, which helps your blood vessels dilate. The plaque build-up can disrupt this process, meaning the vessels (including the arteries) cannot dilate properly. This restricts the amount of blood that can pass through.
What causes high cholesterol?
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High cholesterol typically refers to high levels of LDL or bad cholesterol, which can be caused by several factors. These include:
- Drinking alcohol
- Smoking
- Living a sedentary lifestyle (not exercising enough)
- Being overweight
- Eating a fatty diet
- Genetic factors
“Some people inherit a gene that means their cholesterol levels will be higher than normal,” Dr Desai says. “This condition is known as familial hypercholesterolaemia (FH), and it causes around 10% of early onset coronary artery disease cases. For people with this gene, diet and exercise can seem to only have a marginal impact on their cholesterol levels.”
FH is typically treated using a combination of lifestyle changes and medication. For more information, you can visit the Heart UK website.
How is high cholesterol measured, and how often should you check yours?
Because high cholesterol levels show in the blood, a simple blood test will indicate whether your cholesterol is within a healthy range.
“It’s recommended that all adults get their cholesterol checked,” Dr Desai says. “How often you need to do this should be discussed with a healthcare professional.”
Cholesterol tests can be carried out by taking blood from the arm or using a simple finger prick test, so they’re relatively simple to do. If you’re worried about your cholesterol levels, you should speak to your GP who should be able to book you in for a test.
In general, the following measurements indicate good cholesterol levels for a healthy adult:
- Total cholesterol at 5mmol/L or less
- LDL levels at 3mmol/L or less
- HDL levels at 1mmol/L or greater
What are the signs and symptoms of high cholesterol?
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The tricky thing about high cholesterol is that there are typically no signs or symptoms, which is why so many people with high cholesterol are unaware they have it.
This is a problem, because failing to take action to reduce high cholesterol can lead to health issues down the line. It’s at this stage when you might experience some symptoms, such as chest pain, tightness or shortness of breath triggered by cholesterol-related conditions.
It’s for this reason that taking action to control your cholesterol levels is important, no matter what stage of life you’re at – sticking to habits you know will have a positive impact on your cholesterol levels should keep things ticking along in the background.
How to prevent and reduce LDL cholesterol levels
Most people will be able to reduce their levels of ‘bad’ LDL cholesterol by simply making some healthy lifestyle choices. This will lower your risk of developing harmful conditions in the long term.
1. Up your activity levels
Working at a desk all day can make it all too easy to live a sedentary lifestyle, but prioritising movement and regular exercise can work wonders for your cholesterol.
Not only can moving more lower your levels of LDL cholesterol, but it can also boost your HDL cholesterol levels, boosting the rate at which fats are removed from the bloodstream and flushed out of the body by the liver.
A good goal to aim for is meeting the NHS’ recommended physical activity guidelines, which includes doing at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week.
2. Eat well
When it comes to cholesterol-friendly eating, it’s not rocket science. “Eating foods that are low in trans and saturated fats will help to reduce your cholesterol readings,” Dr Desai explains.
“Focus on wholefoods and avoid ultra-processed food where possible,” she adds. “Instead, try to focus on eating more foods that are low in problematic fats, including fruits, vegetables, whole grains and seeds and beans.”
3. Quit smoking and cut down on drinking
Smoking and drinking alcohol can both contribute to an increase in bad cholesterol, so shaking off these habits is a good idea if you’re concerned about your cholesterol levels.
“Smoking is closely linked with an increased risk of high blood pressure, heart problems, cancer, high cholesterol and premature mortality,” Dr Desai says.
“Excessive alcohol consumption can increase cholesterol levels because it stimulates the liver to increase production of low-density lipoprotein. Alcohol is also linked to weight gain, which goes hand in hand with higher cholesterol levels.”
4. Reduce your blood pressure
Not only can high cholesterol increase your blood pressure, but high blood pressure can lead to higher rates of plaque build-up due to the damage it inflicts on our artery walls.
“Lowering your blood pressure can help reduce your overall risk of heart disease and improve overall heart health by improving your blood flow and circulation,” Dr Desai explains.
The good news is that the lifestyle changes listed above can also have a positive impact on your blood pressure. Other ways to reduce your blood pressure include lowering your salt intake, keeping your stress levels under control and avoiding caffeinated drinks.
When should you see your GP about high cholesterol?
If you have a family history of high cholesterol or are concerned about how your current lifestyle might be impacting your cholesterol readings, it’s worth booking in with your GP to get an up-to-date reading. If high cholesterol levels are detected, they can then recommend appropriate lifestyle changes or prescribe you medications such as statins.
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