High Cholesterol

Seek emergency care immediately for chest pain with shortness of breath, arm pain, or jaw pain. Sudden severe palpitations with dizziness or fainting, leg swelling with breathlessness, or a sudden cold, pale, or blue limb all require urgent medical attention. Do not wait to see if these symptoms pass.

Statin therapy has very strong evidence for reducing cardiovascular events in people with elevated LDL. Dietary modification — particularly reducing saturated and trans fats — has strong supporting evidence. Plant sterols show moderate evidence for LDL reduction. Omega-3 fatty acids have moderate evidence for lowering triglycerides, though effects on LDL are less consistent.

Clinicians assess LDL, HDL, and triglycerides together alongside broader cardiovascular risk factors such as blood pressure, smoking status, age, and family history. In the UK, a total cholesterol above 5.0 mmol/L is a screening threshold, but management decisions are based on overall risk rather than a single number.

Reducing saturated fat and replacing it with unsaturated fats is consistently supported by evidence. Regular aerobic physical activity raises HDL and supports weight management, both of which benefit the lipid profile. Obesity and low activity are modifiable contributors to elevated LDL and triglycerides.

Because high cholesterol produces no symptoms, it is only detected through blood testing. A GP or primary care provider can assess your full lipid profile, calculate cardiovascular risk, and discuss appropriate management. People with a family history of early heart disease or familial hypercholesterolaemia should seek assessment proactively.

Supplements such as red yeast rice or berberine are sometimes used for cholesterol, but evidence is inconsistent and quality varies. No complementary approach has the cardiovascular outcome data that statins carry. Inflated outcome claims in this space are common — always discuss supplements with a qualified practitioner, as some interact with medications.