Cholesterol is a fatty substance which is found in the blood. Most of the cholesterol in the blood is made within the human body, and it plays an essential role in how every cell in the body works as it is an essential part of cells and nerves.Too much cholesterol in the blood can increase your risk of heart or artery disease and high cholesterol is one of the main risk factors for causing heart disease. The cholesterol gets trapped in cells that line the inside of arteries in the heart and in other places in the body, causing narrowing of the arteries, that can reduce the blood flow, and in some cases can cause an artery blockage leading to heart attacks. These narrowings are known as ‘atheromatous plaques’. Cardiovascular disease (CVD) is the leading cause of death affecting people over 50 years old in England and Wales, with smoking, raised blood pressure and raised cholesterol as the other main risk factors. Higher blood cholesterol has a direct relationship with the risk of coronary heart disease and is a key risk factor that can be changed. It is also estimated that in high-income countries blood cholesterol levels in excess of 3.8 mmol/litre are responsible for more than half of all coronary heart disease. Blood cholesterol can be reduced by dietary change, physical activity and drugs. 

Testing for Cholesterol

A small sample of blood is taken usually from the arm and the blood sample is analysed by a laboratory. Your doctor will ask you to fast (not to have food, drinks or other medications for 9 to 12 hours) before the blood test. The laboratory result will give your cholesterol level in milligrams per deciliter of blood (mg/dL). Your doctor will then have to interpret your cholesterol result based on your other risk factors such as your age, your family history, whether you smoke or not and your blood pressure. General cardiovascular risk factors for illnesses such as myocardial infarction (heart attack) include smoking, high blood pressure, high blood cholesterol, diabetes, being overweight or obese and lack of physical exercise. The are also risk reference charts available that will help your doctor advise you on what your risk is likely to be. There are some cholesterol home testing kits available, but these can sometimes be difficult to use and so we do not recommend them.Healthcare professionals should use simple everyday language to discuss cholesterol issues with patients and should engage with patients by discussion of lifestyle modifications and treatments, with timeset aside in consultations to allow questions to be answered, and time for futher consultation if needed. Records of discussions with patients about cardiovascular disease risk should be kept.

Your first port of call for help or advice should be your own doctor, normally your registered general practioner (GP) for advice on cholesterol and other cardiovascular risk factors

LDL Cholesterol and HDL Cholesterol 

Cholesterol is carried in the blood by carrier proteins which are called lipoproteins. There are two main types of lipoproteins:  

* LDL (low-density lipoprotein) is the harmful type of cholesterol protein 

* HDL (high-density lipoprotein) is a protective type of cholesterol protein 


Having too much harmful cholesterol in your blood can increase your risk of getting heart and artery disease. The risk is particularly high if you have a high level of so called LDL cholesterol and a low level of HDL cholesterol. 





Triglycerides are another type of fatty substance found in the human blood and also found in foods such as dairy products, meat, cooking oils and nuts. The body can also produce triglyceride from fat stores or in the liver.


If you are very overweight or eat a lot of fatty or sugary foods, or drink too much alcohol you are more likely to have a high triglyceride level in your blood. People with high triglyceride levels also have a greater risk of getting heart of artery disease than people with lower levels.


What causes high cholesterol?


A common cause of high blood cholesterol levels is eating too much saturated fat. 

However, some people have high blood cholesterol even though they eat a healthy diet. For example, they may have inherited a condition called familial hyperlipidaemia (FH). 

The cholesterol which is found in some foods such as eggs, liver, kidneys and some types of seafood e.g. prawns, does not usually make a great contribution to the level of cholesterol in your blood. It's much more important that you eat foods that are low in saturated fat.




Ways to Reduce Your Blood Cholesterol Level 


1. Eat less saturated fats


Saturated fats are particularly found in meat, cheese, and other convenience foods such as chips or foods cooked in batter and instead use unsaturated fats such as olive, rapeseed or sunflower oils and spreads. You should also reduce the total amount of fat you eat.


2. Eat oily fish regularly


Oily fish provides the best source of a particular type of polyunsaturated fat known as omega-3. Omega-3 oils from oily fish can help to lower blood triglyceride levels and help prevent the blood from clotting, and can also help to regulate the heart rhythm. Omega oil rich fish include sardines, mackerel, and herring, but not whitefish such as cod or plaice,


3. Eat a high-fibre diet


Foods that are high in soluble fibre such as oats, beans, pulses, lentils, nuts, fruits and vegetables, can help lower cholesterol. You can also eat foods rich in natural bran



4. Exercise Regularly


Regular exercise may increase HDL cholesterol, the 'protective' type of cholesterol. 





5. Other Diet Changes 


If you have been told by your doctor that you need to reduce your cholesterol levels, you can do this through changing your diet without using special products. And remember they are not a substitute for a heart healthy diet or a replacement for cholesterol lowering drugs. For most people, the amount of saturated fat they eat has much more of an impact on their cholesterol than eating foods that contain cholesterol, like eggs and shellfish. So unless you have been advised otherwise by your doctor or dietician, if you like eggs, they can be included as part of a balanced and varied diet. 


6. Drugs to Reduce Cholesterol 


Whether you need to take cholesterol-lowering drugs or not depends not just on your total cholesterol, HDL and LDL levels, but also on your overall risk of cardiovascular disease. Cholesterol-lowering medicines such as statins are prescribed for people who are at greatest overall risk of suffering from cardiovascular disease. If you are in doubt you should always consult your own doctor and ask for your blood cholesterol, and other lipids (HDL, LDL and triglyceride) to be checked by a recognised and accredited pathology laboratory and take the advice that your doctor offers. 


ALSO please stop smoking and reduce your alcohol intake as these are two other very important cardiovascular risk factors