Cholesterol is a subject of constant debate. With so much conflicting information around, it is no surprise that people are unsure if they should be worried about their cholesterol levels and what the difference is between good and bad cholesterol.

With Heart UK - the Cholesterol Charity designating October as National Cholesterol Month, it makes sense for us to use this opportunity to discuss everything about this subject and highlight the differences between good and bad cholesterol.

What is cholesterol?

Cholesterol is a fatty substance (also called a lipid) that is naturally made in the liver and is vital for the normal functioning of the body. It can also be found in some foods. Cholesterol is carried in your bloodstream as lipoproteins, of which there are two types:

High-density lipoprotein (HDL) - This carries cholesterol away from the cells and back into the liver where it is broken down or flushed out of the body as waste. This vital function is why HDL is known as ‘good cholesterol’.

Low-density lipoprotein (LDL) - This carries cholesterol to where it is needed but if there are excessive amounts it can build up in the arteries and lead to disease. For this reason, LDL is called ‘bad cholesterol’.

By itself high cholesterol doesn’t normally show any symptoms, but it can have serious effects on health. Studies have shown that it can increase the risk of:  

- Atherosclerosis (narrowing of the arteries)

- A heart attack, or coronary heart disease
 

- Stroke, or transient ischaemic attack – or a ‘mini stroke’​
 

- Blood clots

It stands to reason, therefore, that keeping a close eye on your cholesterol levels and learning to spot the signs of high cholesterol can help to keep you healthy.

What are the signs of high cholesterol?

One of the most common signs of high cholesterol levels is the appearance of tiny yellow lumps on the eyelids. The appearance of such lumps could be an indication of a problem with arterial fatty build-up. If you have noticed these, doctors recommend that you immediately cut down on sugar and lose weight.

Heart UK has dubbed high cholesterol ‘the silent killer’, because there is often no obvious sign that you have it until quite serious problems have begun to show. For example, pain when walking could be caused by a blockage in an artery in the leg. A stroke can strike when one of the arteries in the neck or brain is blocked. Narrowed arteries can cause angina and a blockage in one of the arteries, which supply the heart, can lead to a heart attack.

Other signs that may indicate high cholesterol are:

- Hereditary indications; a parent or sibling could themselves have high cholesterol

- A parent or sibling who has had a heart attack or angina before the age of 50 (for a man) or 60 (for a woman)

- If you are a type 2 diabetic or have high blood pressure

- You are physically inactive, are overweight and have a diet which is high in saturated fats and/or sugar

- If you smoke – this can also lead to narrowing of the arteries

This is not by any means an exhaustive list of signs. You may have all of them, you may have none or one, but it is recommended by the NHS that you ask your GP for a health check if you are worried particularly if you are over 40, by far the best thing you can do is to actively take steps to lower your cholesterol levels.

What can I do to lower my cholesterol levels?

- Switch to and maintain a healthy diet

- Cut down on processed food, especially takeaways and reduce your intake of animal or saturated fats

- Swap fatty food for healthy options like fruit, vegetables and wholegrain cereals

- Exercise every day - this needn’t mean slogging away in the gym if you have mobility issues; a gentle walk every day will help. If you are sedentary most of the day remind yourself to get up and move around at least once an hour

- Stop smoking. See your GP or your local Stop Smoking initiative

In August 2015, the US Food and Drug Administration approved a drug called Repatha for use in injectable form for patients who have difficulty getting LDL under control. However, it will be used in conjunction with dietary changes and statin therapy, and is intended to benefit only a certain type of patient.

By making small but significant lifestyle changes now, you can do much to avoid the need for medication and the difference to your health and life expectancy will be immeasurably improved.

To find out additional information about high cholesterol as a health condition and the cholesterol medications that we provide, please click here.