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High cholesterol typically does not cause symptoms. It is therefore very important to get your cholesterol levels checked and to start treatment if you need it.


If you experience symptoms, they’re more likely to be due to the health problems your high cholesterol causes rather than the cholesterol itself – that is, symptoms that you get when your arteries become narrowed (atherosclerosis). They include:

pain in or near the chest, caused by narrowed arteries going to the heart. This may come on during activity or while you’re resting (unstable angina).

this may come on when exercising, and is caused by narrowed arteries going to your legs.

(transient ischaemic attack or TIA). Caused by a ruptured blood vessel or a blood clot formed when a cholesterol plaque breaks off from an artery wall and blocks part of the blood supply in the brain. Symptoms of a TIA may include your face falling on one side, arm weakness or slurred speech. These symptoms usually get better very quickly, within 24 hours. Symptoms or warning signs of a stroke include the inability to move an arm or leg on one side of your body. and your speech and vision may be affected. A stroke can lead to permanent disability or even death, especially if not treated immediately.

if the blood supply to your heart is blocked, the heart muscle may become damaged. This is a heart attack. You may feel short of breath and have sudden chest pain that may extend down your left arm or left side of the neck.

Multiple Conditions 

High cholesterol tends to come as part of a dangerous package of risks to the heart. This is why people with high cholesterol are more likely to suffer from diabetes and high blood pressure, together with obesity. High cholesterol is twice as common in people with diabetes compared with non-diabetics. Research shows that 48 per cent of men with high blood pressure and 61 per cent of women with high blood pressure also have raised cholesterol.

So managing high cholesterol is even more important if you have these other health problems, or indeed if you already have heart disease. Similarly, if you’ve had a heart attack or stroke, you should start cholesterol-lowering medication.

Some other medical conditions that are also linked to raised cholesterol are kidney and liver disease and an underactive thyroid (hypothyroidism).

Some risk factors for high cholesterol can’t be changed. For instance, there’s nothing you can do about your family or your age!

But if you do have these fixed risks, then it’s even more important to combat the risks you can influence – namely, your lifestyle.

When to see your GP? 

You should see your GP about managing high cholesterol if you answer yes to any of the following questions:

Are you worried you have risk factors for raised cholesterol?

Are you over 40 years old? 

Have members of your immediate family developed heart disease before the age of 55 for a man or 65 for a woman?

Does your family have a history of familial hypercholesterolemia (FH)?

Do you have diabetes or chronic kidney disease?

Have you been diagnosed as having heart disease?

Do you have high blood pressure?

Do you have angina (chest pain) or have you already had a heart attack or stroke?

Do you smoke? 

Are you overweight and fairly inactive?

Your GP will review your risk factors for heart disease and probably suggest you have a cholesterol test.

Getting tested 

The only way to find out your cholesterol level is to have a blood test. This is a simple test that can be carried out by the GP or you can have it done in a pharmacy or use a home test kit. 

Before this test you may be asked not to eat anything for 8 – 12 hours beforehand, or overnight, so that an accurate reading can be taken.

The result of this test will be given to you as a number, which is known as your total cholesterol level.

Understanding your cholesterol numbers can seem complicated. This is what’s measured: 


low density lipoprotein or ‘bad’ cholesterol.


high density lipoprotein or ‘good’ cholesterol.


these are another type of fatty substance in the blood. They are produced by the liver and also found in dairy products, fatty meat, processed food and cooking oils.

Total cholesterol

your doctor may calculate your total cholesterol by adding your LDL and HDL levels together.

If the result shows that your cholesterol is higher than it should be, your GP will discuss with you what changes you can make to your lifestyle that will bring it back down to healthy levels. Depending on what your cholesterol number is and on your other risk factors for heart disease, the doctor may also advise that you take cholesterol-lowering medication.

What does the result mean?

Cholesterol levels are measured in units called millimoles per litre of blood (mmol/L). 

5.0mmol/L: the average total cholesterol level in the UK for men.  It’s 5.1 mmol/L for women.  The government recommends a level of 5.0mmol/L total cholesterol with the LDL being less than 3.0mmol/L. 

Doctors are most worried when someone has high levels of LDL cholesterol and low levels of HDL cholesterol. 

Guidelines suggest that for people who are at risk of developing cardiovascular disease, total cholesterol levels should be less than 4mmol/L and LDL should be less than 2mmol/L. 

If you are worried that you may have high cholesterol or that you are at risk of developing cardiovascular disease, you should speak to your doctor.  If you have diabetes for example, it is likely that your doctor will seek to lower your cholesterol.

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SHS173 - January 2015