Written by Olivia Hunt
10th Oct 2022 • 4 minute read
Reviewed by
Dr Nicole Harris MRCGP BSc (Hons)

There are usually no symptoms of high cholesterol. So the only way to determine if your levels are high is by doing a blood test. If your levels are abnormal, you should check them regularly, as high cholesterol levels can increase your risk of heart disease. But the good news is it's possible to lower your levels through lifestyle changes.

What is high cholesterol?

Cholesterol is a fatty substance found in your blood. So if you have high cholesterol, it refers to high levels of this fatty substance in your blood — sometimes called hyperlipidemia. While some cholesterol is essential, if levels get too high, cholesterol can build up on the walls of your arteries. This is called cholesterol plaque — it narrows your arteries and increases your risk of blood clots, putting you at risk of heart disease.

What causes high cholesterol?

The main causes of high cholesterol are:

  • eating fatty foods
  • not exercising enough
  • being overweight or obese
  • smoking
  • drinking alcohol
  • a genetic condition called familial hypercholesterolaemia (FH)

Which foods are high in cholesterol?

Foods that are high in cholesterol include:

  • creamy or cheesy sauces
  • fatty meat products — like sausages, burgers, pate, salami, meat pies, and pasties
  • crisps and chocolate
  • full-fat milk, cheese, cream, and yoghurt
  • lard, dripping, ghee, butter, and coconut oil

Instead, you should aim to eat more:

  • lean cuts of meat and mince
  • chicken and turkey (without the skin)
  • oily fish — like mackerel, sardines, and salmon
  • fresh fruit
  • lentils, chickpeas, and soya
  • unsalted nuts and seeds
  • vegetable oils — like olive, sunflower, soya, or rapeseed oil and their spreads
  • reduced-fat dairy products — like 1% milk, reduced-fat cheddar, and low-fat yoghurt

What are the symptoms of high cholesterol?

There usually aren’t any signs of high cholesterol, so a cholesterol blood test is the only way to check if you have high levels. Raised cholesterol can indicate an increased risk of heart disease, so you should regularly check your cholesterol levels.

Regular cholesterol testing from a young age is particularly important if you:

  • are overweight or obese
  • smoke
  • have a family history of high cholesterol or heart disease
  • have high blood pressure, coronary artery disease (CAD), or diabetes
  • are on medication for high cholesterol and need to track your levels

Is there a blood test for high cholesterol?

A cholesterol blood test measures a range of fats in your blood — sometimes called a lipid test. This includes measuring your:

  • total cholesterol — your HDL and LDL levels combined
  • LDL cholesterol — the ‘bad’ type of cholesterol that can build up on the walls of your arteries if too high
  • HDL cholesterol — the ‘good’ type of cholesterol that helps remove LDL cholesterol from your body, protecting against heart disease
  • triglycerides — a kind of fat in your blood essential for energy

More advanced tests might measure your apolipoprotein levels — these proteins transport fats like cholesterol in your blood. Evidence indicates that your apolipoprotein levels are better at predicting your risk of heart disease than your cholesterol levels.

You can check your cholesterol levels at home using a cholesterol blood test. Or, you can visit a nurse at a clinic, and they will collect your sample at an extra cost.

What are the risks of high cholesterol levels?

There’s a lot of evidence showing that high cholesterol levels are linked to:

But remember that your cholesterol levels might be normal even if you’ve had a heart attack. Heart disease is very complex, and cholesterol is only part of the picture. Your GP will also check your blood pressure, medical history, and family history.

How to lower your cholesterol

There are lots of things you can do to lower your cholesterol naturally:

  • avoid foods high in cholesterol, saturated fats, and trans fats
  • avoid fast food and fried foods
  • eat high-fibre foods — like fruits, vegetables, and whole grains
  • eat lean sources of protein — like chicken, fish, and legumes
  • eat oily fish — like salmon and mackerel
  • exercise regularly — this can help raise your HDL cholesterol
  • lose weight if you’re overweight
  • don’t smoke

The important thing is to keep track of your cholesterol levels. Making small changes that you can easily stick to is much more effective than trying to make massive shifts in your lifestyle. If you’re concerned, learn more about cholesterol or speak to your GP, who can advise you on the best ways to manage your cholesterol.

If the above lifestyle changes don’t work, sometimes you might need life-long medication to lower your cholesterol levels — typically statins. These help your body reduce the amount of cholesterol it makes. You’ll need to take a tablet daily. If statins aren’t right for you, your GP will prescribe a suitable alternative.