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Cholesterol and your heart

WebMD Feature
Medically Reviewed by Dr Rob Hicks

Cholesterol can be quite confusing to get your head around. Cholesterol must be bad as it's linked to heart disease right? There is definitely a proven link between too much cholesterol and heart disease. 

But it's more complicated than that. We need some cholesterol, and there’s also both bad and good cholesterol in our bodies. The aim is to lower the bad and raise the good.

Yes, high cholesterol is a significant risk factor for heart disease, but that's not the whole story. There are plenty of other risk factors too. Fortunately many of them can be controlled or reduced. 

What is cholesterol?

Cholesterol is a fatty, waxy substance found naturally in the body. We need it to help make hormones, cell membranes, vitamin D and the bile acids that absorb dietary fat.

In the blood, cholesterol is carried all around the body by proteins. Cholesterol and proteins combined make lipoproteins.

Low-density lipoproteins (LDL) are known as the 'bad' cholesterol. High-density lipoproteins (HDL) are known as the 'good' cholesterol.

"LDL cholesterol is often referred to as 'bad cholesterol' because too much is unhealthy. HDL is often referred to as 'good cholesterol' because it is protective," says Jules Payne, chief executive of HEART UK - the cholesterol charity.

"There are both good and bad cholesterol, and the aim is to get the total cholesterol level down to lower the bad cholesterol and raise the good cholesterol," says Maureen Talbot, senior cardiac nurse at the British Heart Foundation.

"Cholesterol is something the body needs, but if you have too much it can start to line the arteries of your heart, which narrow and blood can't get through to the heart muscle as it's needed," adds Maureen, "which can lead to heart disease, stroke or heart attack."

Raised levels of LDL, the bad kind of cholesterol, are a big risk factor for heart attacks, angina and stroke. They slow up your blood flow and can create blood clots. The good kind of cholesterol (HDL) helps get rid of the bad kind by taking it back to your liver, keeping it away from your arteries. 

A cholesterol reading

If you have a cholesterol test from your GP they will explain the reading to you and give you advice on lifestyle change or will prescribe medication depending on your individual circumstance.

"Knowing your levels of LDL and HDL can help explain your risk of heart disease. Your doctor should be able to tell you your levels of 'good' and 'bad' cholesterol after a blood test," says Jules.

It's estimated that more than half of adults in the UK have levels of LDL bad cholesterol that are too high. 

What causes high cholesterol?

There are different reasons why you may have high cholesterol. 

  • Unhealthy diet - Having a diet with too much saturated fat.
  • Smoking – a chemical in cigarettes stops cholesterol from being moved from fatty deposits in the arteries, resulting in narrowing of the arteries called atherosclerosis.
  • Physical inactivity - If you don't do any exercise or are physically inactive it can increase your levels of bad cholesterol.
  • Overweight - If you are obese or overweight you are more likely to have high levels of bad cholesterol and triglycerides. Triglycerides are fats in the blood. A high triglyceride level can also increase your heart disease risk.
  • Drinking too much alcohol – Regularly drinking large amounts can increase your cholesterol and triglyceride levels.
  • Medical conditions - It may be because you have kidney or liver disease or have an inherited condition which causes high cholesterol despite living a healthy lifestyle.

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