High Cholesterol (Dyslipidaemia)
Silent for years — then a major driver of heart attack and stroke.
Dyslipidaemia means an unhealthy balance of blood fats — typically raised LDL ("bad") cholesterol or triglycerides with low HDL ("good") cholesterol. It rarely causes symptoms but builds plaque in arteries over decades. Treatment combines lifestyle change with medication when risk is high enough.
Causes & risk factors
- Diet high in saturated and trans fats
- Low physical activity and excess weight
- Genetics — familial hypercholesterolaemia runs in families
- Type 2 diabetes and metabolic syndrome
- Hypothyroidism and chronic kidney disease
- Some medications (steroids, certain HIV drugs)
Symptoms
- Usually none — diagnosed on a routine lipid panel
- Tendon xanthomas (cholesterol deposits) in severe familial forms
- Chest pain or stroke symptoms once advanced atherosclerosis is present
How it's diagnosed
- Fasting lipid panel: total, LDL, HDL, triglycerides
- Cardiovascular risk score (QRISK, ASCVD, WHO/ISH) to contextualise the numbers
- HbA1c and thyroid function to rule out contributors
- Family history review for inherited lipid disorders
Evidence-based treatment
- Mediterranean-style diet; replace saturated fats with unsaturated
- 150 minutes/week of moderate aerobic exercise
- Weight loss where appropriate
- Statin therapy when calculated risk crosses the local threshold
- Ezetimibe or PCSK9 inhibitors added when statins alone aren't enough
Prevention
- Regular lipid checks from age 40 (earlier if family history)
- Quit smoking — huge effect on overall cardiovascular risk
- Keep blood pressure and HbA1c in target ranges
- Limit alcohol; prioritise sleep
Related symptoms
High Cholesterol (Dyslipidaemia) — FAQ
Do I definitely need a statin if my cholesterol is high?
Not always. The decision is based on overall cardiovascular risk, not the cholesterol number alone. A doctor will calculate your 10-year risk before recommending medication.
Can I manage cholesterol with diet alone?
Many people can move modestly raised LDL into target range with diet, weight loss, and exercise. Familial or severely elevated cholesterol usually needs medication too.
Other conditions
This page is general information, not medical advice for any specific person. For diagnosis and treatment, book a consultation.