High Cholesterol
What is It?
Cholesterol is a fatty substance (lipid) essential for normal body function. However, high blood cholesterol levels are associated with an increased risk of heart attacks and strokes. Cholesterol is carried in the blood in different forms: low-density lipoprotein (LDL or ‘bad’ cholesterol) can collect in artery walls causing narrowing, while high-density lipoprotein (HDL or ‘good’ cholesterol) carries cholesterol back to the liver for breakdown. High cholesterol is very common, affecting over a third of adults, and is a major, often symptomless, risk factor for cardiovascular disease.
What are the symptoms?
High cholesterol typically causes no symptoms until it has caused significant damage to blood vessels, which is why it is often called a ‘silent’ condition. Symptoms only appear once complications such as heart attack, stroke, or peripheral artery disease have developed. In rare cases of severely high cholesterol (often genetic), yellowish skin deposits called xanthomas may develop around the eyes or tendons. This is why regular cholesterol testing is essential.
What are the causes?
At One Heart Centre our cardiologists screen for all causes of high cholesterol. Causes and risk factors include:
- Dietary factors: Diets high in saturated and trans fats.
- Lifestyle factors: Physical inactivity, obesity, smoking and excess alcohol.
- Genetics: Inherited conditions such as familial hypercholesterolaemia.
- Age, gender and hormonal factors, including post-menopausal changes in women.
- Underlying medical conditions: Diabetes, hypothyroidism, kidney disease and certain medications.
How is it investigated?
Cholesterol levels are measured using a simple blood test called a lipid profile, which measures total cholesterol, LDL, HDL and triglycerides. In combination with other risk factors such as age, smoking, high blood pressure, diabetes and family history, the results are used to estimate your overall cardiovascular risk. Your One Heart Centre cardiologist may also arrange additional tests to screen for underlying causes and to assess for early signs of vascular disease.
What are the treatments?
At One Heart Centre our cardiologists have post-fellowship training in managing high cholesterol and will provide a personalised treatment plan for your high cholesterol. Treatment options include:
- Lifestyle changes: Adopting a heart-healthy diet low in saturated and trans fats, regular exercise, weight management, smoking cessation, and limiting alcohol.
- Statin therapy: The first-line and most effective cholesterol-lowering medication.
- Non-statin medications: Ezetimibe, PCSK9 inhibitors, bempedoic acid, bile acid sequestrants, or fibrates in selected cases.
- Ongoing monitoring: Regular blood tests to assess response to treatment and adjust therapy as needed.