In our latest blog Dr Sunil Gupta, GP and Clinical Lead for Cardiovascular Disease for mid and south Essex, discusses the impact of high cholesterol, what you can do to lower your levels, managing your medication as well as how Mid and South Essex Integrated Care System is meeting the challenges of helping our residents and communities manage this silent killer.
Empower your heart: The importance of knowing your cholesterol levels.
Knowing your cholesterol levels can save your life – it is as simple as that. Cholesterol is currently one of the leading causes of deaths worldwide. Cholesterol is a fatty substance that you find in the blood and is referred to as the ‘silent killer’ or asymptomatic, meaning you may not experience noticeable symptoms or potentially unhealthy levels.
High cholesterol is a national issue and as a result, a massive issue for the NHS with research showing that more than two in five people in England have high cholesterol.
The silent killer
The impact of failing to control your cholesterol can be catastrophic. High cholesterol puts you at significant risk of developing heart disease, which is the world’s biggest killer. It annually accounts for around a quarter of deaths in England or 140,000 people dying from the condition each year.
This is because it can lead to narrowing of your arteries, which reduces and blocks blood flow, which can lead to an increased risk of:
- narrowing of the arteries (atherosclerosis)
- heart attack
- transient ischaemic attack (TIA) – often known as a “mini stroke”
- peripheral arterial disease (PAD)
It can also lead to the formation of gallstones, Non-Alcoholic Fatty Liver Disease (NAFLD), pancreatitis, and cause deposits of cholesterol-rich material on the skin and tendons.
Managing your cholesterol risk
There are a number of risk factors which are out of our control that’ll increase your chances of high cholesterol.
Your diet and lifestyle are causes of high cholesterol. There are several main factors including eating fatty food high in saturated fat and having an unhealthy diet, not being active and exercising enough, being overweight, smoking, and drinking alcohol. In addition, diabetes or high blood pressure (hypertension), which are also impacted by diet and lifestyle, will add to your increased risk.
There are also things that you can’t control, which will impact the likelihood of you developing high cholesterol. This includes:
In addition, there are some people that have a genetic condition, which is inherited from your parents, called Familial Hypercholesterolemia. It causes extremely high cholesterol levels even if you don’t have the other risk factors. It affects 1 in 250 nationally, about 220,000 people.
You can read more about Familial Hypercholesterolemia and its symptoms at the British Heart Foundation website.
“Good” and “bad” cholesterol
Cholesterol is a type of lipid and often midunderstood. We need cholesterol to enable the cells in our body to function properly for hormone production as well as helping our liver to break down food.
There are two types of cholesterol – LDL and HDL. LDL is often referred to as “bad” cholesterol, as high levels of LDL can leave to a build up of plaque in arteries leading to increasing the risk of heart disease. HDL is known as “good” cholesterol because it helps remove excess cholesterol from the bloodstream, reducing the risk of plaque formation. There are also triglycerides, which can also contribute to narrowing of the arteries and are also measured as part of the test.
Measuring your cholesterol has been shown to help calculate your risk of developing cardiovascular disease more effectively. Below are the healthy levels for different type of cholesterol:
- Total cholesterol: 5mmol/L or below
- HDL (good cholesterol): 1mmol/L or above for men or 1.2mmol/L or above for women
- Non-HDL (bad cholesterol): 4mmol/L or below
- Your total cholesterol to HDL ratio should be below 6.
If you want to calculate your number, visit the diabetes.co.uk and use their HDL ratio calculator.
Getting yourself tested
By regularly checking your cholesterol your GP can monitor your progress and make necessary adjustments to your lifestyle or medications if needed. This measurement has also been shown to help calculate your risk of developing cardiovascular disease. You can get tested at your GP surgery or clinic and if you’re over 40 you may have a test during your NHS Health Check.
During the test some blood will usually be taken from your arm with a needle and sent to a lab for testing and you’ll get the results in a few days. You can also be tested through a pricking of your finger where a drop of blood is placed on a strip of paper. This is then put into a machine that checks your cholesterol within a few minutes. In some instances, you may be asked not to eat anything for up to 12 hours before the test. but this is not always needed.
Getting yourself treated
As a result of undergoing cholesterol checks your GP will prescribe lipid lowering drugs like statins, which are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood.
Lipid lowering drugs are highly effective and are currently taken by 6.5 million adults in England, and come in tablet form of which there are five different varieties available on prescription in the UK:
- atorvastatin (Lipitor)
- fluvastatin (Lescol)
- pravastatin (Lipostat)
- rosuvastatin (Crestor)
- simvastatin (Zocor)
Facts about statins
Sometimes people stop taking their prescription drugs due to things they have heard or read, or becuase they believe they’re experiencing side effects of the drugs. It’s important to understand the facts about statins, so we’ve created a fact list to answer your questions.
Fact: While statins can have side effects, they’re generally well-tolerated. Most people experience no or only mild side effects. Regular monitoring can catch any potential issues early, and the benefits of lowering cholesterol usually outweigh the risks.
Fact: Statins have been studied extensively, and their long-term safety profile is generally favourable. They’re one of the most widely prescribed medications for heart health. The risk of intreated high cholesterol is likely to be greater than the potential risks associated with statin use.
Fact: Statins are not a substitute for a healthy lifestyle. Patients should continue making dietary and exercise improvements as they can complement the effects of statins and lead to better overall heart health.
If you experience side effects or have concerns or questions about your treatment, don’t just stop taking your statins as they’re essential to you to keep your cholesterol levels under control. Get in contact with your GP and speak to them about your concerns. There are different statins available, so if one doesn’t work for you there are other drugs you can be prescribed.
Reducing your risks and preventing ill health
I advise all my patients to start to lower their cholesterol levels through lifestyle changes. There are a number of things you can do including:
- adopting a heart-healthy diet, reduce saturated fats and managing your portion control,
- Staying physically active,
- maintaining a healthy weight,
- quitting smoking,
- morderating alcohol intake,
- managing stress,
- and seeking regular medical check-ups
Updating your diet
Changing your diet is essential to lowering your cholesterol by reducing saturated fat from red meat, full-fat dairy products, and certain processed foods. Choose healthier fats like those found in olive oil, avocados and nuts, as they can help raise your high-density lipoprotein (HDL) or “good” cholesterol levels.
By choosing food such as oats, beans, fruits, and vegetables you can also increase your soluble fibre and help lower low-density lipoprotein (LDL) or “bad” cholesterol. Also, eating more omega-3 Fatty Acids found in fatty fish like salmon, mackerel, and sardines in your diet, have been shown to reduce triglycerides and lower the risk of heart disease.