What is High Cholesterol?
Cholesterol is a fatty substance in the blood. While some cholesterol is essential for the body, too much of the wrong type – low-density lipoprotein (LDL), or “bad” cholesterol – can lead to heart disease, stroke, and other cardiovascular problems.
Risk Factors for High Cholesterol
You are more likely to have high cholesterol if you have one or more of the following risk factors:
Lifestyle Factors
- Unhealthy diet – Eating too much saturated and trans fat (e.g., processed foods, red meat, full-fat dairy).
- Lack of physical activity – Being inactive can lead to weight gain and lower “good” cholesterol (HDL).
- Smoking – Damages blood vessels and lowers HDL cholesterol.
- Excess alcohol consumption – Can raise cholesterol and triglyceride levels.
Medical Conditions
- Obesity or overweight – Extra body weight increases cholesterol levels.
- Diabetes – High blood sugar contributes to high cholesterol and heart disease.
- High blood pressure (hypertension) – Often linked with high cholesterol.
Genetic & Other Factors
- Family history – If high cholesterol or heart disease runs in your family, you may be at higher risk.
- Age and sex – Cholesterol levels tend to rise with age, and men are at higher risk at younger ages than women.
- Ethnicity – Some ethnic groups (e.g., South Asian, African, or Caribbean descent) have a higher risk of heart disease linked to cholesterol.
How to Lower Your Cholesterol
Healthy Lifestyle Choices
- Eat a heart-healthy diet – Choose whole grains, lean proteins, fruits, vegetables, and healthy fats like nuts, seeds, and olive oil.
- Increase physical activity – Aim for at least 150 minutes of moderate exercise (brisk walking, swimming, or cycling) per week.
- Maintain a healthy weight – Even small weight loss can help lower cholesterol.
- Stop smoking – Quitting can improve your cholesterol and heart health.
Limit alcohol consumption – Drink within NHS guidelines: not more than 14 units per week.
Medications to Lower Cholesterol
If lifestyle changes are not enough, your doctor may prescribe medication.
| Medication Type | How It Works | Common Side Effects |
| Statins – (Atorvastatin, Simvastatin, Rosuvastatin) | Lowers cholesterol production in the liver. | Muscle pain, digestive issues, increased blood sugar. |
| Ezetimibe | Reduces cholesterol absorption from food. | Stomach pain, diarrhoea, tiredness. |
| Bile Acid Sequestrants -(Colesevelam, Colestipol, and Cholestyramine) | Helps remove cholesterol from the body. | Constipation, bloating, nausea. |
| Fibrates – (Fenofibrate) | Lowers triglycerides and increases HDL cholesterol. | Stomach upset, gallstones, muscle pain. |
| Bempedoic Acid | Works in the liver to reduce LDL cholesterol production (alternative for those who can’t take statins). | Muscle pain, gout, increased liver enzymes. |
| (PCSK9)-interfering mRNA – (Inclisiran) | Uses RNA technology to reduce LDL cholesterol by preventing PCSK9 protein production. Given as an injection every 6 months. | Injection site reactions, flu-like symptoms, joint pain. |
| PCSK9 Inhibitors – Repatha (Evolocumab) and Praluent (Alirocumab) | Increases the liver’s ability to remove LDL cholesterol. | Injection site reactions, flu-like symptoms, back pain. |
Important: Medications should be taken as prescribed. Discuss any side effects with your doctor.
1st Line medication – Stains are the most common medicine for high cholesterol. According to guidelines we usually start Atorvastatin 20 mg once daily. Statins need to be taken long-term to be effective. If you commence a statin, you will need a blood test 2-3 months after starting it to check your liver function, and then once yearly after this.
Take Action for Your Heart Health!
✔ Eat well, move more, and maintain a healthy lifestyle.
✔ Get regular cholesterol checks, especially if you have risk factors.
✔ Talk to your GP about the best treatment options for you.
For more information, visit NHS High Cholesterol Guide. Stay heart-healthy! ❤️