High cholesterol, also called hypercholesterolaemia, means there’s more cholesterol in your blood than is considered healthy. Over time, this can raise your risk of serious cardiovascular conditions such as heart attacks, atherosclerosis, strokes, angina, and coronary heart disease.
The good news? High cholesterol can often be managed – and even lowered – through lifestyle changes, medication, or a combination of both. This guide covers the causes, healthy target ranges, lifestyle strategies, and the role of statins.
What causes high cholesterol?
There are two main causes of high cholesterol:
- Genetics – When high cholesterol runs in families, it’s called familial hypercholesterolaemia.
- Lifestyle factors – Most people develop high cholesterol through a mix of diet, lack of exercise, smoking, and excessive alcohol intake. This is called acquired hypercholesterolaemia.
What is considered high cholesterol?
Cholesterol is carried in your blood as:
- HDL cholesterol – “good” cholesterol, which helps protect your heart.
- LDL cholesterol – “bad” cholesterol, which can build up in your arteries.
Blood tests usually measure:
- Total cholesterol
- HDL cholesterol
- LDL cholesterol
- Non-HDL cholesterol
- Triglycerides
There’s no one-size-fits-all “ideal” level. Your targets depend on your overall health and risk factors, so discuss them with your GP. If you’ve had a heart attack or stroke, the recommended cholesterol levels are lower to help reduce risk of another heart attack or stroke.
As a general guide, healthy cholesterol levels often fall within:
Lowering your cholesterol naturally
If your cholesterol is high, the first step is usually to improve your lifestyle.
1. Improve Your Diet
Cut back on foods high in saturated fat and replace them with healthy unsaturated fats.
Eat more:
- Wholegrains (brown rice, wholewheat bread)
- Oily fish (salmon, mackerel, sardines)
- Seeds and nuts
- Plenty of fruit and vegetables
Eat less:
- Fatty meats, sausages, pies
- Butter, lard
- Cream and hard cheeses
- Cakes, biscuits, and sweets
2. Get More Exercise
Aim for at least 150 minutes of moderate-intensity activity per week.
Good options include:
- Brisk walking
- Swimming
- Cycling
- Jogging
3. Quit Smoking and Reduce Alcohol
If you smoke, stopping is one of the most powerful steps you can take for your heart health.
For alcohol, stick to 14 units or fewer per week and avoid binge drinking.
Statins for high cholesterol
If lifestyle changes alone aren’t enough, your doctor may prescribe statins — medicines that lower LDL cholesterol and reduce your risk of heart disease. Common examples include atorvastatin, pravastatin, rosuvastatin, and simvastatin.
You may be prescribed statins if:
- You’re at high risk of developing cardiovascular disease in the next 10 years
- You already have cardiovascular disease
Taking statins
- Usually taken once a day
- Must be taken long-term. Stopping will cause cholesterol levels to rise again
- Most people have no side effects, but mild symptoms like headache or nausea can occur
- Not suitable during pregnancy or breastfeeding
- Always tell your GP about other medicines you take before starting statins
High cholesterol is common but manageable. The best results often come from combining healthy lifestyle habits with medication when needed. Regular monitoring with your GP can help you stay on track and protect your heart for the long term.
Further reading:
