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Cholesterol Reduction

Cholesterol Reduction Information

What is Cholesterol?

Cholesterol is made in the liver and carried in the blood, in cells called lipoproteins. It is a fat chemical (a lipid) that is manufactured by our body from the fatty foods that we eat. There are two types of cholesterol - HDL (High Density Lipoprotein), often called the 'good' cholesterol as it can lessen our chances of developing illnesses such as heart disease, and LDL (Low Density Lipoprotein), the 'bad' cholesterol, which causes fatty deposits to build up in the blood vessels and is therefore dangerous. Usually, about 70% of cholesterol in the blood stream is made up of LDL, but it varies from person to person.

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What causes different levels of cholesterol in the blood stream?

Cholesterol levels are affected by what we eat. Usually, eating lots of fatty foods will be a cause of high cholesterol. However, there can be other causes, such as an underactive thyroid gland or some rare liver and kidney disorders. Heavy drinking and obesity can also raise cholesterol levels. In some people a high cholesterol level runs in the family due to a genetic problem.

What is the right level of cholesterol?

The desirable total cholesterol level (TCL) should be less than 5.0 mmol/l but your doctor will also be interested in the ratio of HDL to TCL. Ideally this ration should also be 5.0 or less.

What can happen if you have high cholesterol?

Raised levels of cholesterol in the blood stream can cause fatty deposits to line the blood vessels, causing them to narrow. The small fatty lumps which develop inside the arteries are called atheroma. Over time, as the vessels narrow due to atheroma, this can reduce the flow of blood through the artery. This leads to conditions such as angina.

Sometimes, a blood clot will form over a patch of atheroma, causing blood to be completely cut off, resulting in a heart attack, stroke, or other serious problems. Atheroma is therefore the cause of various cardiovascular diseases. Cardiovascular problems are a major cause of ill health in the UK, and the biggest cause of death.

Other 'Risk Factors' of Atheroma

Some lifestyle choices put you at risk of developing atheroma. These include being overweight, drinking excessive alcohol, a high-fat diet, eating foods with lots of salt, smoking and not taking enough exercise. Other factors however can also be a cause, namely diabetes, hypertension (high blood pressure), kidney problems, and as we have already mentioned, high cholesterol. Also, those with a family history of heart problems, women who have gone through an early menopause, members of certain ethnic groups and those who are older are more at risk.

If you are already in a group more likely to develop atheroma, it is all the more important you keep an eye on your cholesterol.

How do I lower my cholesterol?

First you need to reduce the 'risk factors' in your life. This means examining your diet and reducing the amount of unhealthy food you eat, cutting down on your alcohol intake, ensuring that you are taking regular exercise and finally if you smoke, making an effort to quit.

Some foods appear to have an ability to bring down LDL cholesterol levels. There is some evidence that foods containing plant sterols and stanols have this LDL lowering influence. These sterols and stanols can be found in products such as margarine spreads, yoghurts and milk drinks. The National Institute for Clinical Excellence does not recommend that people take these food supplements as a method of reducing cardiovascular risk until proper clinical trials have demonstrated their efficacy.

While changing your lifestyle can make a big difference, it may be that your doctor will put you on medicines that help lower your cholesterol levels. Drug treatment is generally advised if you are considered to be in a high risk group, since changing your lifestyle alone will probably not be enough to lower your cholesterol to a safe level.

If you have had a blood test with your doctor that confirms that you have high levels of cholesterol then we may be prepared to prescribe a statin.

Most statins are prescription only medications so you must complete a consultation form before we can make a decision as to whether this is the correct course of action for you. Consultations are free and there is no obligation to make a purchase.

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Reviewed by: Dr Joyce Braaksma
GMC registration number: 4621289
Date: 21 March 2022
Next review: 22 March 2024
All UK registered doctors can have their registration checked on
The Medical Register at the GMC website.

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