Cholesterol is a fatty substance, vital for good health but having too much in your
blood can narrow your arteries preventing blood flow through them.
This puts you at risk of cardiovascular disease (CVD). This is a term used to include:
– Heart Attacks
– Strokes
– Angina
– TIAs (mini strokes)
– Peripheral Vascular Disease
Cholesterol is carried around in the blood by proteins and when combined are called lipoproteins. There are two main lipoproteins that are important.
1 – LDL (low density lipoprotein) – This is known as the “bad cholesterol”. It is involved in the build up of fatty deposits, known as plaques, in the walls of our arteries which restrict blood flow leading to cardiovascular disease.
2 – HDL (high density lipoprotein) – This is known as the “good cholesterol”. It carries cholesterol away from cells, back to the liver where it is broken down and removed from the body.
What are the symptoms of High Cholesterol?
– often NONE and that is why it is so important to have cholesterol checked on a blood test.
– It is often a hidden risk factor for cardiovascular disease, and we don’t know it is there until it is too late, leading to heart attacks and strokes.
What are the causes of high cholesterol?
Things you can control in your lifestyle:
– Eating too much saturated fat.
– Being physically inactive.
– Smoking.
Things you can’t control:
– Your age -your cholesterol tends to increase with age.
– Your sex – males are more likely to have a high cholesterol.
– Your ethnic background – eg if you are of South Asian origin, you are more likely to have high cholesterol.
– Your genes – your close family have high cholesterol despite a very healthy lifestyle. Some people inherit a condition called Familial Hypercholesterolaemia.
– Your general health – if you have liver, kidney or thyroid disease, it can lead to high cholesterol. Also, if you have type 2 diabetes or excess eight, especially around the middle then you are at greater risk of having high cholesterol.
How do we test for high cholesterol?
A simple blood test is taken from the arm and sent to the laboratory. You are asked not to eat or drink anything for 12 hours prior to the blood test other than water so this is often easiest to do in the morning.
We test:
– Total cholesterol
– HDL cholesterol
– LDL cholesterol
– Non-HDL cholesterol
– Total cholesterol to HDL ratio
– Triglycerides (a dietary fat which should be removed mostly from the blood)
What do we do after the blood test?
Following the blood test, it is important to discuss through the results with Dr Lindsey. She will explain them and use them to calculate whether your result is above the normal level expected for your age and gender. She will also calculate your risk of cardiovascular disease over the next 10 years. If these are found to be high, if not done already, you may need a further blood test to check your thyroid is working normally and rule out any other medical reasons why your cholesterol may be high. With this result, we can then plan how to lower your cholesterol levels if necessary. Most of the time, this is achieved through changes to diet and lifestyle. She will advise you about these changes and how to achieve them.
Sometimes however, Dr Lindsey may in addition advise you to take a medicine called a statin. This is decided on an individual basis in discussion with yourself. It is more likely to be advised if you are diabetic, have a genetic cause for high cholesterol, or have another reason for increased risk of heart disease. In general, the newer statins which we prescribe now are safe and well tolerated.
