How your GP can assist with raised cholesterol

Cholesterol is a fatty substance in the blood that plays an essential role in the body. However, when cholesterol levels become too high, it can increase the risk of heart disease, stroke and other cardiovascular conditions. Your GP can provide guidance, diagnosis and treatment options to help manage raised cholesterol effectively.

GP discussing high cholesterol with their patient.

How is raised cholesterol diagnosed?

Your GP can diagnose high cholesterol with a simple blood test, often called a lipid profile. This test measures:

Total cholesterol: The overall level of cholesterol in your blood.
LDL cholesterol ('bad' cholesterol): High levels can lead to plaque buildup in arteries.
HDL cholesterol ('good' cholesterol): Helps remove excess cholesterol from the bloodstream.
Triglycerides: Another type of fat in the blood that can contribute to heart disease.

How does your GP estimate your cardiovascular risk?

Your GP will perform a risk assessment to calculate the estimated cardiovascular disease risk within the next 10 years for people aged 25 to 84 years. This takes into consideration various factors such as your age, ethnicity, smoking status, selected medical and family history, blood pressure, height, weight, total cholesterol/high density lipoprotein (HDL)-cholesterol ratio from a non-fasting blood sample. This assessment should be repeated at least every five years, but earlier if any significant changes occur in the family history.

It is important to remember that certain individuals have familial hypercholesterolaemia, a genetic condition passed down through families and this presents a significantly increased risk of early cardiovascular complications if left untreated.

What lifestyle changes can your GP recommend?

Your GP will usually suggest lifestyle modifications as the first step in managing raised cholesterol, including:

Dietary changes: Reducing saturated fats, increasing fibre intake and incorporating healthy fats from sources like nuts, seeds and oily fish.
Exercise: Engaging in at least 150 minutes of moderate-intensity exercise per week.
Weight management: Maintaining a healthy weight to improve cholesterol levels.
Smoking cessation: Stopping smoking to boost 'good' cholesterol levels.
Reducing alcohol intake: Limiting alcohol consumption to lower triglyceride levels.

When are medications needed?

If lifestyle changes are not enough to lower cholesterol levels, your GP may prescribe medications, such as:

Statins: The most commonly prescribed cholesterol-lowering drugs, which reduce LDL cholesterol production.
Ezetimibe: Helps reduce cholesterol absorption from food.
PCSK9 inhibitors: Injectable medications for people with very high cholesterol or those who do not respond to statins.
Fibrates: usually reserved for patients with very high triglycerides.
Bile acid sequestrants: Medications that help remove cholesterol from the body.

Side effects of statins:

In recent years there has been a fair amount of publicity regarding statins and their potential side effects. It is important to keep in mind that many people who take statins experience no or very few side effects. Others experience some side effects, but these are usually minor, such as occasional diarrhoea, a headache or feeling sick.

The risks of any side effects have to be balanced against the benefits of preventing heart disease, stroke and other cardiovascular conditions. There are a variety of different statins available on prescription in the UK, and sometimes you may need to try different types until you find one that is suitable for you.

How can your GP monitor and support you?

Your GP will schedule regular follow-ups to monitor your cholesterol levels and assess your response to treatment. They may also check for other risk factors, such as high blood pressure or diabetes, and provide additional support, including referrals to dietitians or specialist services if needed.

Managing raised cholesterol is crucial for long-term heart health, and with the right support from your GP, you can take effective steps towards lowering your risk of cardiovascular disease.

If you would like Dr Zemenides to review your cardiovascular risk and you're in London, arrange a consultation now.

Dr Michael Zemenides

Dr Zemenides is a co-founder of The A-Z General Practice at HCA Healthcare UK The Wellington Hospital in St John’s Wood. Dr Zemenides works in close collaboration with Dr Claire Agathou, offering patients and their families dedicated, personalised care across all ages. Together, they provide comprehensive access to on-site services, including blood tests, investigations, advanced imaging, and immediate referrals to world-class specialists.