High cholesterol is a common condition that can increase your risk of heart disease and stroke. Cholesterol is a fatty substance found in your blood. Your body needs some cholesterol to stay healthy, but too much can build up in the blood vessels and cause problems over time.
High cholesterol usually does not cause symptoms. Many people only discover they have it after a blood test. Checking your cholesterol levels and making healthy lifestyle changes can help reduce your risk of future health problems.
What cholesterol does in the body
Cholesterol travels through your bloodstream and plays an important role in how your body works. There are different types of cholesterol:
- LDL cholesterol, sometimes called “bad cholesterol”, which can build up in your arteries
- HDL cholesterol, sometimes called “good cholesterol”, which helps remove excess cholesterol from your bloodstream
When cholesterol builds up in the arteries, it can narrow the blood vessels and reduce blood flow to the heart and brain.
Why it matters for heart health
Too much cholesterol in the blood can increase the risk of serious conditions such as:
- heart attack
- stroke
- other forms of cardiovascular disease
Several factors can increase cholesterol levels, including:
- family history of high cholesterol
- age
- gender
- ethnicity
- menopause
- medical conditions such as diabetes
- an unhealthy diet high in saturated fats
- lack of physical activity
- being overweight
- smoking
- drinking too much alcohol
Understanding these risk factors can help people make informed decisions about their health.
Who should be tested
Cholesterol testing may be offered as part of an NHS Health Check if you are aged 40 to 74 and do not already have cardiovascular disease.
Your GP or healthcare professional may also recommend a test if you:
- have high blood pressure
- have diabetes
- are overweight
- smoke
- have a family history of heart disease
Regular checks can help identify risks early and support prevention.
How testing works
A simple blood test measures the amount of cholesterol in your blood. This may be carried out at your GP practice or during an NHS Health Check.
The test may measure:
- total cholesterol
- HDL (“good”) cholesterol
- LDL (“bad”) cholesterol
- triglycerides
Your healthcare professional will explain what your results mean and whether lifestyle changes or medication could help reduce your risk.
Ways to lower your cholesterol
There are several steps you can take to help reduce cholesterol levels and improve your heart health.
You can:
- eat a healthy, balanced diet
- reduce foods high in saturated fat
- increase fibre in your diet
- stay physically active
- maintain a healthy weight
- stop smoking
- reduce alcohol intake
- take medication if prescribed by your doctor
Small, sustainable changes could make a significant difference over time. However, for some, lifestyle changes alone are not enough and they will need medicine to lower their risk.
Cholesterol and overall cardiovascular risk
Cholesterol is only one factor that affects heart health. Other factors such as blood pressure, smoking, diabetes and physical activity also influence cardiovascular risk.
Healthcare professionals often assess these factors together to understand your overall risk and recommend the most appropriate support.
If you are concerned about your cholesterol, speak to your GP, pharmacist or practice nurse. They can help you understand your results and support you to improve your heart health.
Cholesterol-lowering medication (statins)
Statins are the most common cholesterol-lowering medication. They are safe, well‑researched and work well for most people. There are different types of statins and your doctor will choose the right type and dose for you. If statins do not work for you, other cholesterol-lowering medicines can be offered.
If you are prescribed medicine for your cholesterol, it is likely you will need to take this for the rest of your life. It’s important to keep taking it as prescribed, even if you feel well.