Overview
Cholesterol is a fatty substance found in your blood that is produced naturally by your liver and also comes from the food you eat. Your body needs a certain amount of cholesterol to build healthy cells, produce hormones, and make vitamin D. However, when cholesterol levels become too high, it can build up on the walls of your arteries, forming a substance called plaque. Over time, this plaque narrows and hardens the arteries, a condition known as atherosclerosis, which restricts blood flow to vital organs including the heart and brain. This significantly increases your risk of serious cardiovascular events such as heart attacks and strokes. According to the NHS, high cholesterol is extremely common in the UK, with an estimated two in five adults affected. The condition is particularly dangerous because it rarely produces noticeable symptoms, meaning many people are unaware their levels are elevated until a serious health event occurs.
Not all cholesterol is harmful. There are two main types that you should be aware of. Low-density lipoprotein, commonly known as LDL or bad cholesterol, carries cholesterol from your liver to the cells throughout your body. When there is too much LDL cholesterol, it builds up in the artery walls and increases your risk of heart disease. High-density lipoprotein, known as HDL or good cholesterol, carries excess cholesterol away from your arteries and back to the liver, where it is broken down and removed from the body. Having higher levels of HDL cholesterol is protective and reduces your cardiovascular risk. There is also a type of fat called triglycerides, which are stored in fat cells and released for energy. High triglyceride levels, combined with high LDL and low HDL, further increase your risk. A standard cholesterol blood test, also called a lipid profile, will measure all of these components. The British Heart Foundation provides detailed guidance on understanding your cholesterol results and what they mean for your heart health.
High cholesterol can be caused by a combination of lifestyle factors and genetic predisposition. A diet high in saturated fats, found in foods such as fatty cuts of meat, full-fat dairy products, butter, cakes, biscuits, and processed foods, is one of the most common causes. Being physically inactive reduces your levels of HDL cholesterol and allows LDL to accumulate. Being overweight or obese, particularly if you carry excess fat around your waist, increases your risk. Smoking damages the walls of your blood vessels, making it easier for cholesterol to build up, and also lowers your HDL levels. Drinking excessive amounts of alcohol raises both cholesterol and triglyceride levels. Some people have a genetic condition called familial hypercholesterolaemia, which causes very high cholesterol levels from birth regardless of lifestyle. Other medical conditions such as type 2 diabetes, an underactive thyroid, liver disease, and kidney disease can also contribute to elevated cholesterol. The NHS explains the causes of high cholesterol in more detail and offers guidance on reducing your risk factors.
High cholesterol does not usually cause any symptoms, which is why it is often called a silent condition. You cannot feel whether your cholesterol is high, and there are no visible warning signs in most cases. The only reliable way to know your cholesterol level is through a blood test. This is why regular health checks are so important, especially if you are over 40, have a family history of cardiovascular disease or high cholesterol, are overweight, have diabetes or high blood pressure, or smoke. In very rare cases, extremely high cholesterol caused by familial hypercholesterolaemia may produce visible signs such as yellowish deposits around the eyes called xanthelasma, small lumps on the tendons of the hands, knees, or Achilles tendon called xanthomas, or a pale white ring around the coloured part of the eye called corneal arcus. If you notice any of these signs, you should speak with your GP. The NHS recommends that all adults over 40 have their cholesterol checked as part of an NHS Health Check, and your local pharmacy can also help with cholesterol awareness through our NHS Blood Pressure Check service.
Making changes to your diet and lifestyle is the first and most important step in managing high cholesterol. Reducing your intake of saturated fats by choosing lean meats, low-fat dairy, and cooking with unsaturated oils such as olive oil or rapeseed oil can make a significant difference. Increasing your intake of soluble fibre, found in oats, beans, lentils, fruit, and vegetables, helps to bind cholesterol in the gut and remove it from the body. Eating oily fish such as salmon, mackerel, and sardines at least twice a week provides omega-3 fatty acids that help lower triglycerides. Plant stanols and sterols, found in some fortified spreads, yoghurts, and milk drinks, can help reduce LDL cholesterol when consumed regularly. Regular physical activity, aiming for at least 150 minutes of moderate-intensity exercise per week, raises your HDL levels and helps you maintain a healthy weight. Stopping smoking improves your HDL cholesterol within weeks and significantly reduces your cardiovascular risk. Reducing alcohol intake also helps lower both cholesterol and triglycerides. The NHS Eatwell Guide provides practical advice on building a heart-healthy diet, and the HEART UK charity offers free resources specifically for people managing cholesterol.
If lifestyle changes alone are not enough to bring your cholesterol levels down to a safe range, your doctor may recommend medication. The most commonly prescribed cholesterol-lowering drugs in the UK are statins, such as atorvastatin and simvastatin, which work by reducing the amount of cholesterol your liver produces. Statins are highly effective and have been shown to significantly reduce the risk of heart attacks, strokes, and cardiovascular death. Like all medications, statins can cause side effects in some people, including muscle aches, digestive problems, and headaches. If you experience side effects, speak with your doctor or pharmacist rather than stopping the medication, as there are different types and doses that may suit you better. Other cholesterol-lowering medications include ezetimibe, which reduces cholesterol absorption in the gut, bile acid sequestrants, and PCSK9 inhibitors for patients with very high cholesterol who do not respond to statins. If you have been prescribed a statin or any cholesterol medication, our New Medicine Service provides free follow-up consultations to ensure your treatment is working effectively and to address any concerns you may have. Our Prescription Dispensing service ensures your medication is dispensed accurately and on time.
High cholesterol rarely occurs in isolation. It is often accompanied by other cardiovascular risk factors such as high blood pressure, type 2 diabetes, obesity, and a sedentary lifestyle. When these conditions coexist, the combined effect on your heart and blood vessels is far greater than any single risk factor alone. High blood pressure damages the artery walls, making it easier for cholesterol to accumulate and form plaques. Diabetes accelerates the process of atherosclerosis and increases the likelihood of blood clots. This is why a comprehensive approach to cardiovascular health is essential, addressing all risk factors together rather than focusing on just one. Getting your blood pressure checked regularly is a simple and important step. Our free NHS Blood Pressure Check service is available at all Allied Pharmacies branches without an appointment. Combining regular blood pressure monitoring with cholesterol awareness gives you and your healthcare provider a much clearer picture of your cardiovascular risk. The British Heart Foundation risk factors guide explains how these conditions interact and what you can do to reduce your overall risk.
Your local Allied Pharmacies branch is well placed to support you in managing your cholesterol and overall cardiovascular health. Our pharmacists can provide confidential advice on dietary and lifestyle changes that may help lower your cholesterol, explain how your cholesterol medication works and help you manage any side effects, offer free NHS Blood Pressure Checks to assess your combined cardiovascular risk, provide structured support through our New Medicine Service if you have recently started a statin or other cholesterol medication, ensure your prescriptions are dispensed accurately and on time through our Prescription Dispensing service, and refer you to your GP or other NHS services if further investigation or treatment is needed through our Pharmacy First consultations. No appointment is necessary for most of these services. Simply walk into your nearest branch and speak with one of our trained pharmacists in confidence.
High cholesterol is one of the most common and preventable risk factors for heart disease and stroke in the UK. Because it has no symptoms, the only way to know your levels is through a blood test. If you are over 40 and have not had a cholesterol check, or if you have a family history of heart disease or high cholesterol, speak with your GP about arranging a lipid profile test. You can also request an NHS Health Check which includes cholesterol testing alongside other cardiovascular risk assessments. In the meantime, visit your nearest Allied Pharmacies branch for a free NHS Blood Pressure Check, advice on heart-healthy living, and support with any cholesterol medication you may be taking. For more information on cholesterol and heart health, visit the NHS high cholesterol guide, the British Heart Foundation, or HEART UK. To find your closest Allied Pharmacies branch, visit www.alliedpharmacies.com. Your heart health matters, and small changes today can make a big difference tomorrow.