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A person's risk of having high cholesterol depends on many different factors. Some of these factors can be reduced with lifestyle changes.

High cholesterol doesn't usually cause any symptoms, and is often picked up during routine medical checks. Some people with high blood cholesterol develop small, white lumps in the skin under their eyes or around joints. These are xanthomata which are deposits of cholesterol under the skin.

If your risk factors for high cholesterol are high, your risk of developing coronary heart disease may also be increased.

Cholesterol is a waxy fat-like substance made in the liver and found in certain foods such as full-fat milk, eggs and fatty meats. The body needs some cholesterol in order to function properly. However, too high a level of total and LDL (low density lipoprotein) cholesterol can contribute to an increased risk of heart disease. There are several factors that contribute to high cholesterol - some are controllable while others are not.

Uncontrollable risk factors include:

  • Genetics: Familial hypercholesterolaemia is a condition of high cholesterol that runs in a family.  Once identified, all family members are assessed and treated, and children are screened for cholesterol levels from youngsters onwards.
  • Gender: After menopause, a woman's LDL-cholesterol level (‘bad’ cholesterol) goes up, as does her risk of heart disease.
  • Age: Your risk increases as you get older. Men 45 years old or above and women 55 years old or above are at increased risk of high cholesterol.
  • Family history: Your risk increases if a father or brother was affected by early heart disease (before age 55) or a mother or sister was affected by early heart disease (before age 65).
  • Ethnic background. People from Indian, Pakistani, Bangladeshi or Sri Lankan origins are at an increased risk of high cholesterol.


Controllable risk factors include:

  • Diet: The closer your diet is to the ‘Mediterranean style diet’ - which features vegetables, fruits, beans, wholegrains, olive oil and oily fish - the better your blood cholesterol levels and the healthier your heart is likely to be.
  • Weight: Being overweight can increase both total and LDL-cholesterol levels, and the inflammation associated with being obese can increase risk of heart disease.
  • Physical activity/exercise: Increased physical activity helps to lower LDL-cholesterol and raise HDL-cholesterol (the ‘good’ cholesterol) levels. It also helps you lose weight.
  • Too much alcohol: Regularly drinking alcohol beyond recommended guidelines can increase cholesterol and triglyceride levels.
  • Smoking. Chemicals in cigarettes affect 'good cholesterol' and increase the risk of atherosclerosis, or narrowing of the arteries.
  • Some medical conditions can also cause high cholesterol, including kidney disease, liver disease and underactive thyroid. Treatment of these can help manage blood cholesterol levels. 

Dietitian reviewed by Catherine Collins RD



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