High cholesterol

High cholesterol does not usually cause symptoms. You can only find out if you have it from a blood test.

You can help lower your cholesterol by eating healthily, getting more exercise, stopping smoking and cutting down on alcohol.

Some people may need to take medicines such as statins to help lower their cholesterol.

High cholesterol does not usually cause symptoms. You can only find out if you have it from a blood test.

Your GP might suggest having a test to check if your cholesterol level is high.

This may be because of your age, weight or a condition you have (like high blood pressure or diabetes).

• you have not had a test before and you're over 40, overweight, or high cholesterol or heart problems run in your family

You're more likely to have high cholesterol.

You can also get a cholesterol test at a pharmacy, but you might have to pay for it.

There are 2 ways of having a cholesterol test.

Taking blood from your arm

Some blood will usually be taken from your arm with a needle.

This is sent to a lab to check your cholesterol level. You should get the result in a few days.

You might be asked not to eat anything (to fast) for up to 12 hours before the test. But most people do not need to fast.

Finger-prick test

If you're over 40, you may have a test during your NHS Health Check. You can also get this check at a pharmacy.

This is a check-up that can help spot early signs of problems like heart disease and diabetes.

The test can be done by pricking your finger. A drop of blood is put on a strip of paper. This is put into a machine that checks your cholesterol in a few minutes.

To reduce your cholesterol, try to cut down on fatty food, especially food that contains a type of fat called saturated fat.

You can still have foods that contain a healthier type of fat called unsaturated fat.

Check labels on food to see what type of fat it has in it.

Try to eat more:

• oily fish, like mackerel and salmon
• olive oil, rapeseed oil and spreads made from these oils
• brown rice, wholegrain bread and wholewheat pasta
• nuts and seeds
• fruits and vegetables

Try to eat less:

• meat pies, sausages and fatty meat
• butter, lard and ghee
• cream and cheese
• cakes and biscuits
• food that contains coconut oil or palm oil

Exercise more

Aim to do at least 150 minutes (2.5 hours) of moderate intensity exercise or 75 minutes of vigorous intensity activity a week.

Some good things to try when starting out include:

• walking – try to walk fast enough so your heart starts beating faster
• swimming
• cycling

Try a few different exercises to find something you like doing. You're more likely to keep doing it if you enjoy it.

Stop smoking

Smoking can raise your cholesterol and make you more likely to have serious problems like heart attacks, strokes and cancer.

If you want to stop smoking, you can get help and support from:

• your GP
• NHS stop smoking services

They can give you useful tips and advice about ways to stop cravings.

Cut down on alcohol

Try to:

• avoid drinking more than 14 units of alcohol a week on a regular basis
• spread your drinking over 3 or more days if you regularly drink as much as 14 units a week
• have several drink-free days each week

Ask your GP for help and advice if you're struggling to cut down.

You might need medicine to lower your cholesterol if:

• your cholesterol level has not gone down after changing your diet and lifestyle
• you're at a high risk of having a heart attack or stroke

Ask your doctor about the medicines you can take.

Statins

Statins are the most common medicine for high cholesterol.

They reduce the amount of cholesterol your body makes.

You take a tablet once a day. You usually need to take them for life.

Other medicines for high cholesterol

Other medicines may be used if statins do not work or you cannot take statins.

These include:

• other tablets – such as ezetimibe, sometimes with bempedoic acid
• injections – such as alirocumab, evolocumab and inclisiran