High Cholesterol

Hypercholesterolaemia / Hyperlipidaemia

The definition of high cholesterol and whether it needs to be treated is not made purely on the numbers obtained from the your blood test.

The blood result of total cholesterol (TC) is made up of HDL (“good”) and LDL (“bad”) cholesterol. You may have a high cholesterol but also have a high HDL, which would be less of a concern.

The need for treatment would be based on any other risk factors you may have for developing heart disease. These are classically:

  • Diabetes
  • Smoking
  • Hypertension
  • A family history of heart attacks under the age of 60

There are other factors that can increase your risk.

If you have had a CTCA or invasive angiogram which shows furring up of the heart arteries (atherosclerosis), there is very good evidence that aggressively managing your risk factors will reduce your risk of a future heart attack. This would normally lead to a recommendation to start on a statin. Apart from lowering your cholesterol, statins have other benefits which are detailed further on the Coronary Disease page.

There is some controversy with regards the prescription of statins in patients who have not had a heart attack or cardiac procedure. As with the prescription of any medication, your doctor has to be convinced that the benefit of the drug outweighs any potential risk of being on the drug.

Much is made of the side-effects of statins. The commonest are muscle aches and pains. Individual statins can also give rise to other symptoms – mood or sleep disturbance for example. There are a number of statins on the market and it is rare that a patient is intolerant to all.

There are non-statin medications that reduce cholesterol but these are less effective at lowering your overall risk.

Lifestyle measures such as diet and exercise can lower your cholesterol but it is unusual to reduce your levels by more than 20% with this alone.