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What is Cholesterol?

Cholesterol is a lipid (fat chemical) that is made in the liver from fatty foods that we eat. A certain amount of cholesterol is present in the bloodstream. You need some cholesterol to keep healthy. Cholesterol is carried in the blood as part of particles called lipoproteins. There are different types of lipoproteins, but the most relevant to cholesterol are:

• Low density lipoproteins carrying cholesterol - LDL cholesterol. This is often referred to as 'bad cholesterol' as it is the one mainly involved in forming atheroma. Atheroma is the main underlying cause of various cardiovascular diseases. Usually, about 70% of cholesterol in the blood is LDL cholesterol, but the percentage can vary from person to person.

• High density lipoproteins carrying cholesterol - HDL cholesterol. This is often referred to as 'good cholesterol' as it may actually prevent atheroma formation.

High levels of cholesterol lead to fatty deposits that can cause your arteries to narrow (atherosclerosis) and restrict blood flow to the heart. This is what causes cardiovascular disease. Within the UK cardiovascular disease is the single most common cause of death. You can reduce the risk of cardiovascular disease with a combination of lifestyle changes and medicines such as statins, which work by blocking an enzyme needed for cholesterol production.

Anytime Doctor's service does not replace your GP. Regular check-ups with your GP or nurse are required every year, or sometimes more frequently. Our online doctor can only prescribe treatment if a patient provides their GP details. Anytime Doctor will write to your GP to let them know we have supplied you with treatment.

All services provided by Anytime Doctor are safe, fast and confidential. You can obtain treatment within the privacy of your home and without the inconvenience of waiting for an appointment.

What is a high cholesterol level?

The following levels are generally regarded as desirable:

• Total cholesterol (TC) - 5.0 mmol/l or less. However, about 2 in 3 adults in the UK have a total cholesterol level of 5.0 mmol/l or above
• Low-density lipoprotein (LDL) cholesterol after an overnight fast: 3.0 mmol/l or less
• High-density lipoprotein (HDL) cholesterol: 1.2 mmol/l or more
• TC/HDL ratio: 4.5 or less. This is your total cholesterol divided by your HDL cholesterol and reflects the fact that for any given total cholesterol level, the more HDL, the better.

As a rule, the higher the cholesterol level, the greater the risk to health. However, your level of cholesterol has to be viewed as part of your overall cardiovascular health risk. The cardiovascular health risk from any given level of cholesterol can vary, depending on the level of your HDL cholesterol, and on other health risk factors that you may have.

What factors can impact my cholesterol levels?

In most people, your cholesterol level reflects the amount of fat that you eat. This is not the full story as different people who eat the same amount of fat can make different amounts of cholesterol. However, in general, if you eat less fat your cholesterol level is likely to go down.

In some people, a high cholesterol level is due to another condition. For example, an under active thyroid gland, obesity, drinking a lot of alcohol, and some rare kidney and liver disorders can raise the cholesterol level.

In some people, a very high level of cholesterol runs in the family due to an inherited genetic problem with the way cholesterol is made. One example is called familial hypercholesterolaemia.

Do I need a cholesterol blood test?

Certain people should have a cholesterol blood test as part of a 'cardiovascular risk assessment'. These include: all people aged 40 or more, people at any age with a strong family history of early heart disease or stroke, and people at any age with a family history of a hereditary lipid (cholesterol) disorder. If you are found to have a high risk of developing heart disease or stroke then you will usually be advised to take a statin drug to lower your cholesterol level. As a rule, no matter what your cholesterol level is, lowering the level reduces your risk.

What lifestyle changes can I make to lower my risk of developing heart disease or stroke?

Lifestyle factors that reduce the risk of heart disease or stroke include: not smoking, choosing healthy foods, a low salt intake, regular physical activity, keeping your weight and waist size down, and drinking alcohol in moderation. Your blood pressure is also important.