Cholesterol is a fatty substance made mostly by the liver that is vital to the proper functioning of the human body. Also known as a lipid, the substance can be found in proteins carried by the blood and having an excessively high level of lipids can have a detrimental effect on your health.

When proteins and lipids combine, they become something known as lipoproteins. There are two main types: high density lipoprotein (HDL) and low density lipoprotein (LDL).

‘Good’ cholesterol and ‘Bad’ cholesterol

The job of high density lipoproteins is to carry cholesterol away from the cells back to the liver. There, it is either broken down, or passed out of the body as waste, and for this reason HDL is known as ‘good cholesterol’ and higher levels are encouraged by NHS Choices.

Low-density lipoprotein, on the other hand, is referred to as ‘bad cholesterol’. This is due to fact that the job of LDL is to carry cholesterol to cells that need it, but if there is an excess of cholesterol for the cells to absorb, it can build up in the artery walls, restricting the blood flow to the heart, brain and the rest of the body.

High cholesterol and the risks

The recommended levels of cholesterol in the blood vary between those that are at higher or lower risk of developing arterial disease. Blood cholesterol is measured in units known as millimoles per litres of blood, which is shorted to mmol/L.

Therefore, as a general guide, the NHS suggests that for healthy adults, HDL levels should be 5mmol/L or less, while those at high risk should be at 4mmol or less.

In addition, LDL levels should be 3mmol/L or less for healthy adults and 2mmol/L or less for those at high risk.

NHs evidence has suggested that having high levels of cholesterol can severely increase the risk of serious health problems such as atherosclerosis (narrowing of the arteries), heart attack, stroke, transient ischaemic attack (a mini stroke) and peripheral arterial disease. The risk of a blood clot developing somewhere in your body also increases, as does the risk of developing coronary heart disease.

How can I lower my cholesterol?

There are many factors that contribute to high cholesterol levels and increase your chances of developing heart disease. Certain lifestyle choices such as a poor diet, smoking and a lack of exercise are several contributing factors that can be remedied naturally with a few changes to your daily life.

It is important to eat a healthy balanced diet and to reduce your intake of saturated fat to lower your cholesterol levels. Some common foods that are high in saturated fat that you should avoid include sausages and fatty cuts of meat, butter, cheeses, cream, cakes and biscuits. Instead try to replace these saturated fats with unsaturated fats in foods such as nuts and oily fish, as these can reduce blockages in the arteries and increase levels of ‘good cholesterol’ in the blood.

Smoking can also contribute to high cholesterol levels, as a chemical in cigarettes called acrolein prevents HDL transporting fatty deposits to the liver. This also means that smoking puts you at higher risk of heart attack and strokes. If you have high cholesterol levels the NHS strongly advises cutting down or giving up smoking and provided dedicated advice and treatment to help you do so.

The NHS also recommends being active and exercising regularly to lower your cholesterol levels. Being overweight can increase the amount of bad cholesterol in your blood and regular exercise can not only help you maintain a healthy weight, but will help lower your blood pressure by keeping your heart and blood vessels in good condition. For the best results, the NHS recommends doing 150 minutes (2 and a half hours) of moderate-intensity exercise every week. Walking, swimming and cycling are all excellent ways to incorporate this exercise into your daily life.

Common treatments

If you have been diagnosed with high cholesterol your GP may advise one of several types of cholesterol-lowering medication.

Statins, a medication that block the enzyme in your liver that makes cholesterol, may be prescribed if you are at continued high risk of heart disease. This type of medication is taken for life as cholesterol levels start to rise when you stop taking them. Statins are very widely prescribed, but are well known to cause significant muscle aching. If you experience leg pains both sides, chronic back pain for no reason, aching in the neck shoulders or hips, you should go back to your GP to check you are on the correct dosage.

Your GP may also prescribe a low daily dose of aspirin, depending on your age and other risk factors. This can help prevent blood clots forming, especially if you have had a heart attack before.

A medication called ezetimibe blocks the absorption of cholesterol from food and juices into your blood. This medication may be prescribed if you are unable to take statins due to side effects, or if statins alone are not enough to lower your cholesterol levels.