High Cholesterol is a silent threat that lurks in the bodies of millions worldwide, contributing to the global burden of heart disease and stroke. While cholesterol is needed by the body in moderate amounts, too much of it can lead to serious health issues over time. It is crucial to recognise and manage your cholesterol levels to maintain heart health and prevent life-threatening complications. 

In this blog, we will cover what cholesterol is, why high levels are a major health concern, how it is diagnosed, the various medication, lifestyle treatment options available, and what steps you can take if you have been diagnosed with high cholesterol. 

Whether you’re newly diagnosed, looking to prevent high cholesterol, or seeking to optimise your treatment plan, this ultimate guide offers practical advice to help you take control of your cholesterol levels and enhance your overall well-being.

Understanding Cholesterol

Before we dive into the specifics of high cholesterol, let’s walk through exactly what cholesterol is. Cholesterol is a fatty-like substance that is vital for the proper functioning of the body. Despite its bad reputation, it is crucial for overall health and wellbeing when maintained at optimal levels. 

It is produced naturally by the liver, with most of the cholesterol supply coming from internal production rather than external food sources. The body needs it to work – it is used by every cell, helps make vitamin D and some hormones, and is a component of bile. 

There are a few key types of cholesterol to understand: 

  • LDL Cholesterol: known as “bad cholesterol”, this builds up on the walls of your arteries causing plaque buildup over time which narrows and hardens them. 
  • HDL Cholesterol: often called “good cholesterol”, this carries LDL cholesterol back to your liver where it is removed from your body. High levels of HDL can lower your risk for heart disease. 
  • Triglycerides: a form of fat found in your blood, with high triglycerides often accompanying high LDL levels and accelerate atherosclerosis. 

Cholesterol levels vary from person to person, but in general the lower the LDL and non-HDL, the better, and the higher the HDL, the better. The key is maintaining appropriate cholesterol levels.

Why Is High Cholesterol A Concern?

High Cholesterol levels, especially LDL cholesterol, is concerning if left untreated for a long time. This is because it can cause a dangerous condition called atherosclerosis (a buildup of plaque inside your artery walls which causes them to harden and narrow, restricting blood flow). 

The reduced blood flow from this condition puts you at a high risk for a heart attack and a stroke. It starves vital organs and tissues of oxygen and nutrients carried in the blood. Atherosclerosis and cholesterol-caused blockages often cause angina (chest pain) and can damage blood vessels that feed the heart itself. 

Additionally, beyond heart health impacts, studies show high cholesterol also puts you at greater risk for cognitive problems, poor kidney and liver health, issues with fertility, hormone imbalance, and a weakened immune system. 

There are also no obvious physical symptoms or warning signs of high cholesterol – you often can’t detect the silent plaque buildup happening inside arteries over years. This is why elevated cholesterol levels left untreated for long periods can be so dangerous – severe blockages may have already developed by the time problems present. 


As mentioned, high cholesterol often has no physical symptoms. You may feel completely healthy and still have elevated cholesterol levels that put you at risk. This is why regular testing is so important. 

Cholesterol levels are measured through a blood test which measures your levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. 

Ideally, the levels should be (but these are simply guidelines): 

  • Total cholesterol should usually be 5mmol/L or below 
  • HDL (good cholesterol) should usually be 1mmol/L or above 
  • Non-HDL (bad cholesterol) should usually be 4mmol/L or below 
  • Total cholesterol to HDL ratio should usually be 6 or below 

The result of your test will help your doctor determine your goal cholesterol levels, what your risk of developing heart disease is, and whether you might need medication. 


If you’ve been diagnosed with high cholesterol, there are treatment options available such as cholesterol-lowering medications and lifestyle changes. These treatment plans are tailored based on the severity of your high cholesterol, your heart disease risk factors, and your specific cholesterol goals. 


For many, lifestyle changes alone aren’t enough to lower high cholesterol. Your doctor may prescribe one or more of the following cholesterol-lowering medications to help with your condition: 

  • Statins: these work by reducing the production of cholesterol made by your liver. Examples of statins include atorvastatin and rosuvastatin. 
  • Ezetimibe: works by reducing cholesterol absorption in the small intestine. 
  • Fibrates: these help to reduce triglyceride levels and can raise HDL cholesterol levels. A couple of examples include fenofibrate and gemfibrozil. 

Lifestyle Changes 

It is also possible to manage and reduce your cholesterol levels by making certain diet and lifestyle changes. 

A good way to reduce your cholesterol is to eat fewer fatty foods, especially food that contains a type of fat called saturated fat. You should try and eat more food such as: 

  • oily fish, like mackerel and salmon 
  • brown rice, wholegrain bread and wholewheat pasta 
  • nuts and seeds 
  • fruits and vegetables 

Increasing the amount of exercise is also beneficial, aiming for at least 150 minutes of exercise a week. This can include doing things such as walking, swimming and cycling. You should try doing something you like doing. You’re more likely to keep doing it if you enjoy it. 

It goes without saying that stopping smoking and cutting down on alcohol will also help improve your cholesterol levels. 

It’s important to understand that though lifestyle measures can help, in some circumstances you may still be recommended to take medication as well.

Next Steps

It is crucial to understand that managing high cholesterol is a lifelong commitment to your heart and overall health. By taking steps such as consulting with healthcare professionals, making lifestyle changes, and taking medication, you can ensure you keep your cholesterol at a healthy level long-term. 

At e-Surgery, we understand the challenges of managing high cholesterol. Our team provides you with the support, resources, and care you need to improve your health. Whether you have questions about medication, need advice on lifestyle changes, or simply seek reassurance, you can use our ‘Ask-a-Pharmacist’ service where you can talk to a trained healthcare professional. We are always happy to help!