High cholesterol

Cholesterol is a fatty substance known as a lipid. Having an excessively high level of lipids in your blood can have an effect on your health. This page has information on what you can do to help lower your cholesterol level.

About cholesterol 

Cholesterol is needed for the body to function normally. It's mainly made by the liver, but can also be found in some foods. High cholesterol itself doesn't usually cause any symptoms, but it increases your risk of serious health conditions.

Cholesterol is carried in your blood by proteins. When the two join, they're called lipoproteins.

The two main types of lipoprotein are: 

  • high-density lipoprotein (HDL) – HDL is known as ’good cholesterol’, and higher levels are better
  • low-density lipoprotein (LDL) – can build up in the artery walls, leading to disease of the arteries; for this reason, LDL is known as ’bad cholesterol’

The amount of cholesterol in the blood – both HDL and LDL – can be measured with a blood test.

Lowering cholesterol 

Evidence indicates that high cholesterol can increase the risk of:

This is because cholesterol can build up in the artery wall. This restricts the blood flow to your heart, brain and the rest of your body. It also increases the risk of a blood clot developing somewhere in your body.

Your risk of developing coronary heart disease also rises as your blood's cholesterol level increases. This can cause pain in your chest or arm during stress or physical activity (angina).

Causes of high cholesterol 

Many factors can increase your chances of having heart problems or a stroke if you have high cholesterol.

These include:

There's also an inherited condition which can cause high cholesterol even in someone who has a healthy lifestyle and does not have other risk factors.

Getting tested for cholesterol levels  

Your GP may recommend that you have your blood cholesterol levels tested if you:

You should probably be asked not to eat for 10-12 hours before the cholesterol test, usually including when you're asleep at night. This ensures all food is completely digested and won't affect the outcome of the test.

Cholesterol levels

After your cholesterol test, your GP or nurse will explain your results and calculate whether you have a high, moderate or low risk of developing heart disease, stroke or other circulation problems (cardiovascular disease) within the next 10 years.

However, this risk isn't just based on your cholesterol reading. It also takes into account:

  • your BMI (body mass index) – which measures your weight compared to your height
  • treatable risk factors – such as high blood pressure (hypertension), diabetes and other medical conditions
  • your age, sex, family history and ethnicity

As a general guide, total cholesterol levels should be:

  • 5mmol/L or less for healthy adults
  • 4mmol/L or less for those at high risk

Based on your results, your GP or nurse will recommend steps you can take to reduce your risk of developing cardiovascular disease (see below). Cholesterol-lowering medication, such as statins, may also be recommended.

Things to help lower cholesterol level 

The first step in reducing your cholesterol is to maintain a healthy, balanced diet. It's important to keep your diet low in fatty food.

You can swap food containing saturated fat for fruit, vegetables and wholegrain cereals.

Other lifestyle changes, such as taking regular exercise and giving up smoking (if you smoke), can also make a big difference in helping to lower your cholesterol.

If these measures don't reduce your cholesterol and you continue to have a high risk of developing heart disease, your GP may prescribe a cholesterol-lowering medication

Your GP will discuss treatment options with you.


The information on this page has been adapted from original content from the NHS website.

For further information see terms and conditions.

This page was reviewed February 2019

This page is due for review November 2021

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