High cholesterol usually goes unnoticed. No pain, no warning, which is exactly what makes it tricky. Over time it can slowly raise your cardiovascular risk. Some people carry an inherited form that affects roughly 1 in 250 people. Here's when cholesterol is too high, where it comes from and what you can do.
When is your cholesterol too high?
Cholesterol is called high when your LDL or total cholesterol sits above target, usually above 5.0 mmol/L total or 3.0 mmol/L LDL. Whether that's a real problem depends on your whole risk profile. The full reference values are in our guide to cholesterol, and your LDL value weighs heaviest.
Causes of high cholesterol
It's often a mix of lifestyle and genetics. LDL particles are the direct driver of arterial plaque (Ference et al., 2017). Saturated fat, overweight, low activity, smoking and heredity all play a role. Familial hypercholesterolaemia often stays unnoticed (Nordestgaard et al., 2013). It also affects your triglycerides.
High cholesterol in women and menopause
Cholesterol gives no symptoms, in women either. What stands out: around menopause many women see their cholesterol rise, linked to falling oestrogen (Matthews et al., 2009). The only reliable way to know is a blood test.
What can you do?
For most people it starts with lifestyle: less saturated fat, more fibre, regular movement, no smoking. See lowering cholesterol without medication. The balance between your good and bad cholesterol matters too, explained in LDL and HDL cholesterol.
You can test with a lipid profile, without a referral. Discuss a raised result with your GP. Every blood test result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
References
- Ference BA, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. Eur Heart J. 2017. PMID: 28444290.
- Nordestgaard BG, et al. Familial hypercholesterolaemia is underdiagnosed and undertreated. Eur Heart J. 2013. PMID: 23956253.
- Matthews KA, et al. Cardiovascular risk factors and the menopausal transition. J Am Coll Cardiol. 2009. PMID: 20082925.
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