What’s my Cholesterol Level – is it ok?

Should I have My Cholesterol Checked?
This is currently a very common question being asked at the surgery. The level of cholesterol in the body is one of many risk factors for coronary heart disease (CHD) such as angina (chest pain on exertion) and heart attacks. CHD is very important as currently about 5% of the population have CHD and at least another 4% are at high risk of developing it. It is also the leading cause of death in UK and this is increasing. Basically, if you have CHD or are at high risk of getting it, then your cholesterol level is more important.

Risk Factors
Risk factors we cannot alter are our age, sex and family history. Men are at increased risk compared to women (although this trend is changing as more women are smoking) and as we get older our risk of CHD increases with it. Family history means if you have a first degree relative (parent, sibling, child) who has developed or died from CHD under 60yrs or two relatives under 65yrs. “My great grandmother died of a heart attack aged 95” is not significant.
Risk factors we can alter are very important as we can do something about it!! It is obviously better to do something about it BEFORE we have angina or get a heart attack as the damage will have already been done. Remember, that heart attacks are a common cause of sudden death and these people no longer have the choice! Prevention is better than cure.
The main risk factors are:-

1. Smoking. You are at substantially increased risk of CHD and this must be addressed as a priority. If cancers don’t get you, CHD probably will. If you stop smoking, it will be the best thing you can ever do to reduce your risk of getting CHD as well all the other nasty stuff.
2. Diabetes. If you are diabetic then you are at increased risk of all vascular disease which includes not only CHD, but strokes and poor limb circulation leading to amputation. Diabetic patients are considered very high risk and need the strictest control of their cholesterol.
3. Blood Pressure. Have your levels checked regularly, at least yearly over the age of 50 and earlier if you have these other risk factors. Smoking, weight and excess alcohol all raise your blood pressure.
4. Weight. Overweight patients are at increased risk also.
5. Exercise. This has a beneficial effect on your cholesterol and if you take regular exercise three times a week, this will help. Exercise boosts your “good cholesterol” and displaces some of your bad cholesterol as well as helping to lose weight. If you don’t bother exercising, your risk increases and remember exercise is free.

Cholesterol  - at last !!!
This is number six in the list and is left last as the importance of the cholesterol level you have will depend on the impact of all the above risk factors. They all need to be considered together.
We have risk factor prediction charts at the surgery and nurses / doctors can use these to predict your risk of developing CHD. If you have angina, diabetes or have had a heart attack and haven’t had your cholesterol checked in the last 18 months then make an appointment now! You don’t need these charts as your risk has already been identified.
If you are not one of these then you need to address all the risk factors mentioned and make an appointment so we can inform you how important they are. If you are at low risk, then unless there is a strong family history then we may not even recommend you even need your cholesterol checked for a number of years.
If we think you need a cholesterol then we can use this to measure your risk of developing CHD. We can also at this time offer you other advice such as stopping smoking etc. There is very little point in being concerned about your cholesterol if you continue to smoke 20 a day, take no exercise and are overweight!
If we identify you as high risk then we will enter you into our CHDmanagement system, which means that you will be asked to attend fairly regularly at one of our new clinics where we will follow you up to see how you are managing to reduce your risk. If your cholesterol level, together with your additional risk factors make you at high risk then you will be offered statin therapy. These drugs help to lower cholesterol level and are used alongside a cholesterol lowering diet. You will need some baseline blood tests before you commence therapy and after any increase in dose. Thereafter, you will usually require a test once a year.

What should my level be?
Not all cholesterol is bad for you! We need a certain amount of cholesterol to make the cell walls of our body. Total cholesterol is basically made up of two components, your “bad” cholesterol (called LDL by doctors) and “good” cholesterol” (HDL). When we measure your risk we use the ratio of total cholesterol to good cholesterol to interpret the risk factor charts. This is because HDL benefits the body and if this is > 1 it is good for you. Exercise and moderate alcohol consumption (14 units / wk for women and 21 units / wk for men) increase your HDL. So it’s not all bad news!!!
If you have diabetes or already have CHD then we need to get your “bad” cholesterol (LDL) to below 3. Recent evidence has shown that the statin drugs should be considered for ALL these groups regardless of what their level is as the fact that they have developed CHD or diabetes shows their cholesterol levels are too high anyway. Your doctor will provide more information on this for you.

We will add to this page, depending on feedback from our patients. We regret that we cannot answer individual or personal questions online.

The information contained on this site is general information which is not in any way intended to replace the specific advice that patients may obtain from their own doctor about individual care.

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