High Cholesterol Consultations & Treatments
Cholesterol is a
natural substance that is essential for a person to be healthy.
It’s an important part of normal cell membranes and it’s needed
to make other things in the body – such as hormones – including
the sex hormones and adrenaline, bile and vitamin D. It’s a
fatty substance known as a lipid and is mainly made in the liver
– although some cholesterol is obtained from the food we eat.
is important in the normal, healthy body, high levels of
cholesterol (hypercholesterolaemia) can be dangerous as it
increases the risk of serious health problems.
What do you need to know about the types of cholesterol?
carried in the blood bound to proteins and when bound together
in this way they are called lipoproteins. Lipoproteins fall into
two main groups known as high-density lipoproteins (HDL) and
low-density lipoproteins (LDL).
HDL-cholesterol (’’good’’ cholesterol)
cholesterol from the cells back to the liver, where it is
destroyed or removed from the body as waste. HDL is therefore
referred to as ‘good cholesterol’ and higher levels can have a
positive effect on health.
LDL-cholesterol (’’bad’’ cholesterol)
cholesterol from the liver to the cells of the body. If there is
more cholesterol than the body needs, this cholesterol can build
up in the walls of arteries that carry blood to our major body
organs including the heart and brain. This build-up of
cholesterol can increase the chances of the arteries becoming
clogged and therefore narrowing. This, in turn, can cause heart
attacks, strokes, thrombosis, angina, or other serious problems.
For this reason, LDL is often referred to as ’bad cholesterol’.
It is possible to
determine whether you have high cholesterol by a simple blood
test. A GP may ask you to have this blood test if he or she
thinks you may be at risk from high cholesterol because you have
certain medical conditions such as heart disease, high blood
pressure, stroke or mini-stroke, diabetes or thyroid problems.
You may also be asked to have a cholesterol test simply because
you are overweight, over the age of 40, or if you have a family
history of high cholesterol or cholesterol-related problems. A
combination of these things will increase the likelihood that
you will be asked to take a test. The blood is normally taken
first thing in the morning to ensure that all food you have
eaten has been digested and so will not affect the results of
If you think that
you need a cholesterol test you should speak with your GP. It is
now also possible to have a cholesterol level test conducted by
the Pharmacy2U Online Doctor service for a fee using a small
sample of blood taken from a finger prick. If you would like to
do a blood test, please carry out a cholesterol consultation and
our GP will authorise the test if it is deemed appropriate for
The results from
your blood test will provide a measure of your total cholesterol
level, your LDL level, your HDL level and the HDL level as the
percentage of LDL.
levels for a healthy adult are as follows:
Total cholesterol - 5 mmol/L
LDL - 3 mmol/L or less
HDL - 0.9-1.5 mmol/L
HDL (%) - 20% and above
What are the risks associated with high cholesterol?
supports the fact that high levels of cholesterol significantly
increase the risk of a narrowing of the arteries, also known as
atherosclerosis. The arteries become partially blocked by
cholesterol and other fatty substances. These blockages are
called atheromas or plaques. This is serious because the
blockages reduce the blood flow to the important parts of the
body where it is needed, stopping them from working properly.
Depending on which artery is narrowed, this can cause muscle
pain in the legs, heart disease and, in men, erectile
dysfunction. If the plaque or blockage breaks away from the wall
of the artery it can then block an artery completely causing a
stroke or a heart attack. Atherosclerosis is also worsened by
high blood pressure, smoking, being overweight and diabetes.
These factors in combination with high cholesterol can be very
What are the
causes of high cholesterol?
There are a number
of factors that can contribute to high cholesterol levels.
are important. A diet high in saturated fats can contribute to
high cholesterol. A sedentary lifestyle will also create higher
cholesterol, so people who do not take regular exercise are
thought to be at a higher risk. Smoking stops HDL from carrying
cholesterol back to the liver for destruction and so this is
also bad news. Drinking excessive alcohol can also increase
another major factor. Some people are genetically predisposed to
high cholesterol, including certain ethnic groups (Indian,
Pakistani, Bangladeshi or Sri Lankan). In addition, some people
have high cholesterol that runs in the family. This is called
familial hypercholesterolaemia, affects about 1 in 500 people,
and is inherited from a parent. In this case, lifestyle is not
the cause of the problem and extremely fit and healthy people
can have high cholesterol – no matter how healthy their
How can you lower cholesterol levels?
cholesterol levels can be very damaging, it is possible to treat
the condition in a number of ways.
are important and should always be attempted. Try looking at the
Change your diet
Maintain a diet
that is low in saturated fats, and high in fresh fruit,
vegetables and wholegrain fibre.
If you smoke, it's
very important to quit if you want lower your cholesterol. If
you need assistance, please visit the Pharmacy2U Online Doctor
section on smoking cessation.
What are the differences between the cholesterol-lowering
In most cases, and
as long as your health profile suggests they are safe for you,
statin drugs are recommended first because they are known to be
very effective at lowering LDL-cholesterol levels and are very
well tolerated by most people.
All statins work
in the same way, so the choice of a particular statin for you as
recommended by the doctor comes down to other factors. These can
include their cost, how they are taken, and what other medicines
you might be taking. For example:
Some statins are available
generically (for example, branded Lipitor is also available
as generic atorvastatin).The generic version works in just
the same way as the branded version, but is less expensive.
Some statins are best taken
in the evening (for example, simvastatin), but others can be
taken at any time of day.
Some statins should not be
taken with other medicines or foods (for example,
simvastatin should not be taken with warfarin or grapefruit
juice, but rosuvastatin does not interact significantly with
If you do not wish
to take a statin, or if you have had side effects with them
before, Ezetrol (ezetimibe) may be a good choice. There is
another group of cholesterol-lowering medicines, called ‘fibrates’,
which your own doctor may consider prescribing in these