Frequently Asked Questions About Cholesterol
What is a normal cholesterol level in the UK?
There is no single cholesterol target that is right for everyone. As a general guide for healthy adults, total cholesterol is usually considered desirable below 5 mmol/L and LDL cholesterol below 3 mmol/L. Your ideal level may be considerably lower if you have cardiovascular disease, diabetes, familial hypercholesterolaemia or other cardiovascular risk factors.
What does a high LDL cholesterol level mean?
A high LDL cholesterol level means there is more cholesterol being carried in particles that can enter the artery wall and contribute to atherosclerosis. Persistently raised LDL cholesterol is associated with a higher risk of heart attack and stroke, so the result should be interpreted alongside your age, blood pressure, family history and overall cardiovascular risk.
When should I see a cholesterol specialist or lipidologist?
A lipid specialist may be helpful if your cholesterol is very high, you have a strong family history of premature heart disease, your cholesterol remains above target despite treatment, you have high triglycerides or raised Lp(a), or you have experienced statin side effects. A specialist can also assess possible inherited cholesterol disorders such as familial hypercholesterolaemia.
What is familial hypercholesterolaemia?
Familial hypercholesterolaemia, often shortened to FH, is an inherited condition that causes high LDL cholesterol from birth. It can substantially increase lifetime cardiovascular risk if untreated. FH may be suspected when LDL cholesterol is particularly high or when there is a family history of heart attacks, strokes or coronary disease at a young age.
Can I get a private cholesterol blood test without a GP referral?
Yes. You can arrange a private cholesterol blood test without a GP referral. Testing can include a standard lipid profile and, where appropriate, more detailed cardiovascular risk markers such as ApoB and lipoprotein(a), or Lp(a). The results can then be interpreted in the context of your individual cardiovascular risk.
What is lipoprotein(a), or Lp(a)?
Lipoprotein(a), usually written as Lp(a), is an inherited lipoprotein that can increase the risk of cardiovascular disease independently of standard LDL cholesterol. Lp(a) levels are largely determined by genetics and are not routinely included in a standard cholesterol test. Testing can be particularly useful when there is a family history of premature cardiovascular disease.
Can I have an Lp(a) test privately in the UK?
Yes. Lp(a) testing can be arranged privately and usually only needs to be measured once because levels are predominantly genetically determined. The result should be interpreted alongside LDL cholesterol, ApoB, family history and your overall cardiovascular risk.
What if I cannot tolerate statins?
If you develop possible statin side effects, this does not necessarily mean that all cholesterol-lowering treatment has to stop. A specialist assessment can review the symptoms, previous statins and doses used, look for other possible causes, and consider alternative dosing strategies or non-statin cholesterol-lowering treatments where appropriate.
Is a high cholesterol result always dangerous?
Not necessarily. The significance of a cholesterol result depends on which lipid measurement is raised and on your overall cardiovascular risk. A mildly raised result in someone at otherwise low risk may have very different implications from the same result in someone with established cardiovascular disease, familial hypercholesterolaemia or a strong family history.
Do I need a lipid specialist, or can my GP manage high cholesterol?
Most straightforward cases of high cholesterol can be managed effectively in primary care. Specialist lipid assessment becomes particularly useful when cholesterol is unusually high, an inherited condition is suspected, treatment is not achieving the desired response, statin intolerance is causing difficulty, or additional risk markers such as Lp(a) need interpretation.
