High Cholesterol

Whilst there are no high cholesterol symptoms, it’s important to get your cholesterol levels checked, try to eat healthily and get regular exercise in order to keep cholesterol levels low. Some people with consistently high cholesterol may go on to have a heart attack or develop heart disease. This is because bad cholesterol clogs and damages the interior walls of the arteries and may cause atherosclerosis. This can lead to heart failure due to the heart being put under more pressure and becoming less functional over time. Heart attacks occur when the blood supply in an artery is blocked. For more information on how high cholesterol and atherosclerosis affect the heart, visit the British Heart Foundation website.

High cholesterol can also lead to strokes, again due to arteries becoming damaged or blocked. Read more about stroke and high cholesterol risks.

Since there are no high cholesterol symptoms, it is good to know your cholesterol levels by getting them checked. There are home testing kits available but these are not proven to be as effective as having a test at your GP surgery or pharmacy, so the latter is usually the best option. It’s important to have cholesterol checked at age 40 and then regularly onwards. If you have a family history of high cholesterol, you should tell your GP and have regular checks, probably from an earlier age.

Cholesterol is tested via a blood test and this measures both low density lipoprotein and high density lipoprotein levels. Cholesterol is measured in millimoles per litre of blood, so your result will read in units mmol/L. You may also have levels of triglycerides tested at the same time as cholesterol – this is another fat used in the body. Read more information on how a diagnosis of high cholesterol is made.

If you are given a high cholesterol diagnosis from a healthcare professional, you may need to make lifestyle changes to reduce your cholesterol and will need to monitor your dietary cholesterol.

Read more information on high cholesterol symptoms and high cholesterol diagnosis.

There are a number of different types of drug medications used as high cholesterol treatments, such as:

• Statins – this type of drug reduces cholesterol in the bloodstream by stopping the liver making so much cholesterol. They help people who are at risk of heart disease and often need to be taken for life. Examples include atorvastatin and simvastatin. People with familial hypercholesterolaemia often have to take statins. Learn more about statins

• Aspirin – low doses of aspirin help reduce the risk of blood clots developing, which can cause heart attacks and strokes

• Ezetimibe – this stops cholesterol being absorbed into the blood, and has fewer side effects than statins. Learn more about ezetimibe

• Bile acid sequestrants (resins) – used when other medications do not work, bile acid sequestrants stop the body re-absorbing bile acids, which in turn lowers cholesterol levels because one function of cholesterol is to make bile

• Fibrates – this high cholesterol treatment works by slowing the cholesterol build up in arteries to reduce the risk of heart attack, heart disease, stroke, etc

• PCSK9 inhibitors – these are new drug treatments for high cholesterol and work by stopping the PCSK9 protein being made in the liver. Usually prescribed if you have very high levels of cholesterol, or have already had a heart attack or stroke, and traditional medications are not working well enough. Read more about PCSK9 inhibitors

• LDL-apheresis – similar to dialysis, this process filters blood through a machine to remove cholesterol and then puts it back in the body, and is usually used for people with familial hypercholesterolaemia, or who have very high cholesterol where other high cholesterol treatments are not working. Read more about LDL-apheresis

Read on to find out more about diet and exercise for high cholesterol.

Having a high cholesterol diagnosis may affect your day-to-day life depending on the severity of your condition and how much it is impacting your health. If a person is considered to be at risk of heart attack or stroke, or has perhaps already experienced one of these conditions as a result of high cholesterol, they may have to make drastic lifestyle changes to ensure they lower their cholesterol. Even those with slightly raised cholesterol will be advised to try and lower it by changing their diet, increasing their activity levels and making other lifestyle changes.

You may be advised to:

• Eat more healthily – following a diet for high cholesterol is really important, because saturated fat in foods we eat raise the body’s cholesterol levels. Cholesterol is contained in foods we eat but generally people are advised that high cholesterol foods do not make a big difference to blood cholesterol levels. Eating a balanced, varied and healthy diet is more important. There are lots of foods that can actually help reduce cholesterol

• Increase your exercise/activity levels – exercise lowers levels of bad LDL cholesterol and increase good HDL cholesterol, so it helps keep the arteries and the heart healthy, as well as reducing the risk of other health conditions

• Quit smoking – cigarettes, cigars, tobacco and shisha all contain chemicals that harm the body, making bad LDL cholesterol stick to the artery walls, and lower good HDL cholesterol levels. There is lots of support and help for quitting smoking. Read more about why smoking affects cholesterol levels. For advice on quitting smoking, visit the Smoke Free website

• Cut down on alcohol – alcohol turns into triglycerides and cholesterol in the liver, which raises levels of these and causes liver function to decrease, resulting in the liver being unable to remove cholesterol from the body. Read more about how to cut down your alcohol intake, or stop drinking altogether

It may help to read stories from other people living with high cholesterol.

You may be interested in exercise aids for high cholesterol which can help you start a home exercise programme – these products are safe and comfortable to use, even for beginners:

o Pedal exerciser

o Resistance band

o Dumbbells

NRS Healthcare has a team of occupational therapist product advisors who can advise what products may be useful to you. Contact them on 0345 121 8111 or email [email protected]

Eating a healthy, balanced diet is important if you have a high cholesterol diagnosis, and this may help to prevent high cholesterol in the first place.

Reducing your consumption of saturated fats is important, which is likely to be found in these foods:

• Biscuits, baked goods, cakes

• Chocolate

• Processed meats i.e. sausages and bacon

• Full fat dairy i.e. cheese, milk, cream, yoghurt

• Animal fats i.e. butter, ghee, lard, suet, dripping

• Meat i.e. fatty types such as lamb, beef, duck and pork

• Other oils i.e. coconut oil and palm oil

This is because saturated fat can raise blood cholesterol and make the liver less able to remove cholesterol from the body. Read about how to eat less saturated fat.

Some foods are naturally high in cholesterol, such as eggs, offal and certain types of seafood, but it’s unlikely you need to cut down on these as it will make little or no difference to your overall blood cholesterol.

Some foods actually help reduce the amount of blood cholesterol, including:

• Soya i.e. soya milk, edamame beans, soya sausages, Quorn, etc

• Nuts

• Oats

• Sterol and stanol foods i.e. Benecol yoghurts and spreads

• Fruit

• Vegetables

• Oily fish

• Avocado

• Vegetable oils i.e. olive oil, rapeseed oil

• Seeds i.e. sunflower seeds, pumpkin seeds, etc

• High fibre foods i.e. wholemeal bread and cereals, pulses, skin-on potatoes

Read more about cholesterol lowering foods.

There are lots of foods that are high in unsaturated fat, which is a better type of fat for the body, such as oily fish, nuts and avocados. Read more about fats in foods.

Some people take vitamins and minerals as supplements for high cholesterol, such as omega 3, plant sterols and garlic. You should always check with your GP or nurse before taking high cholesterol supplements.

It is possible to reduce your blood cholesterol levels through subtle dietary changes. Read this personal story about how lifestyle changes can lower cholesterol.

Read general healthy eating advice from the NHS Change4Life website.

Exercise for high cholesterol

Regular physical activity is really important to a person’s overall health and wellbeing, especially if they have high cholesterol. Exercise increases the amount of good HDL cholesterol and decreases the amount of bad LDL cholesterol. Being physically active also helps lower blood pressure and helps reduce the risk of heart problems, stroke and diabetes.

There are lots of ways to get active – you don’t have to join a gym. Adults should try to achieve 150 minutes of exercise per week.

Read more information and advice about increasing your exercise levels.

High cholesterol and employment

High cholesterol is rarely a barrier to employment but you may wish to explain your high cholesterol diagnosis to your employer. You may need to take time off occasionally for medical appointments to have your cholesterol checked or you may have side effects from medication that make your working day difficult. Many people with high cholesterol work as normal and make recommended lifestyle changes to help reduce cholesterol levels.

High Blood Pressure and High Cholesterol Help – a Facebook group for people with high cholesterol to share tips, advice, information and personal experiences

British Heart Foundation – a charity supporting people with heart problems and related conditions such as high cholesterol and atherosclerosis, featuring online information, leaflets, and a heart helpline

Heart UK – a charity providing support, information and education to families with raised cholesterol, including a helpline, factsheets and real life stories

Kidney Patients UK – a charity supporting people with kidney conditions, which also features information and advice about high cholesterol, and its link to kidney health

NHS – source of official medical information about causes, symptoms and treatments for high cholesterol and related conditions

Stroke Association – information and advice about high cholesterol and how it may cause stroke

Arteries

– tubes in the body that carry blood

Atherosclerosis

– a condition where plaque builds up in the arteries, causing them to narrow, which may lead to heart disease and other health conditions

Bile

– fluid found in the body which aids digestion and is released by the liver

Cardiovascular disease

– a group of conditions affecting the heart and blood vessels, such as heart disease, heart attack, atherosclerosis or angina

Cells

– the building blocks of life, which give the body structure and carry out essential functions such as converting nutrients into energy within the body

Cholesterol

– found in the body’s cells, this waxy substance can build up in the body, for instance in the arteries, which can lead to heart disease

Dialysis

– medical process of removing waste products or fluid from the blood

Heart attack

– block of blood supply to the heart

Membrane

– a protective coating that acts as a barrier; in the case of cells, it allows in some particles and denies access to others that could be harmful

Omega 3

– occurs naturally in foods such as fish, this is important for brain and heart health

Proteins

– in the blood, proteins transport hormones, vitamins, and other components around the body

Saturated fat

– a type of fat that causes high cholesterol

Statins

– drugs that can lower levels of bad cholesterol in the blood

Sterols and stanols

– substances in plants that help block cholesterol from being absorbed in the body, which is added to some brands of foods such as spreads and yoghurts to help lower cholesterol levels

Triglycerides

– fat which is stored in the body in fat cells, which is released later when energy is required in between meals

Vitamin D

– essential vitamin used by the body that helps bone growth and maintenance