The battle against cardiovascular disease: Why cholesterol control matters

Cholesterol is a key risk factor in cardiovascular disease, highlighting the importance of its management for both prevention and treatment.

This article provides an expert insight into the impact of cholesterol on cardiovascular health, and the steps you can take to manage it, lower your risk of heart disease, and lead a healthier life.

What is cholesterol?

Cholesterol is a fatty, waxy substance found in every cell of the body. It’s essential for many physiological functions, including cell membranes, hormone production, vitamin D, and substances that help digest foods. It’s produced in the liver and is also obtained through certain foods, primarily from those of animal origin.

Cholesterol circulates in the bloodstream in two forms: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL is commonly known as “bad cholesterol” because it can deposit on the walls of the arteries, causing blockages. HDL, on the other hand, is known as “good cholesterol” because it helps transport excess LDL back to the liver for disposal.

How does cholesterol contribute to cardiovascular disease?

High levels of LDL cholesterol can lead to the buildup of fatty deposits, known as plaque, within the arterial walls. This process, known as atherosclerosis, clogs arteries and reduces blood flow, leading to severe complications such as angina, heart attack, and stroke. Over time, these plaques may also rupture, creating clots that further obstruct blood flow.

What lifestyle changes can help lower cholesterol?

Making lifestyle changes is often the first step to managing high cholesterol levels. This approach typically includes:

• A healthy diet: A diet rich in fruits, vegetables, whole grains, and lean proteins can help lower LDL levels. Foods high in soluble fibre, like oats, beans, and apples, absorb cholesterol in the digestive tract. Including healthy fats from sources like nuts, seeds, and olive oil, is also important. Fatty fish, such as salmon, which is rich in omega-3 fatty acids, supports heart health as well.
• Regular physical exercise: Practising at least 150 minutes of moderate-intensity aerobic activity per week can raise HDL cholesterol and reduce LDL cholesterol levels. Activities like brisk walking, cycling, or swimming are excellent options.
• Quitting smoking and limiting alcohol: Smoking damages blood vessels and accelerates plaque buildup. Meanwhile, excessive alcohol intake can harm the liver and raise triglyceride levels, another harmful blood fat linked to heart disease.

Are medications necessary to control cholesterol?

For some people, lifestyle changes alone may not be enough to lower LDL cholesterol levels to a healthy range. In such cases, medications like statins may be prescribed. Statins work by reducing the liver’s production of cholesterol and helping the body reabsorb cholesterol from plaques in the arteries. Other medications, such as bile acid sequestrants or PCSK9 inhibitors, may be recommended depending on the patient’s specific needs.

Surgery is rarely required solely for cholesterol management, but may be necessary to treat complications arising from high LDL cholesterol, such as severe blockages in the arteries. Procedures like angioplasty or bypass surgery may then be performed to restore blood flow to the heart.

How often should I monitor my cholesterol levels?

Regular cholesterol monitoring is essential for understanding and managing your risk of cardiovascular disease, as high cholesterol often has no noticeable symptoms.

Most adults in the UK are recommended to have their cholesterol checked with a lipid profile every 5 years. This test involves a simple blood draw, typically performed after fasting for several hours. The results provide information about your LDL, HDL, and total cholesterol, along with triglycerides. Based on these results, your specialist will assess your cardiovascular risk and develop an appropriate management plan.

People with risk factors, such as a family history of heart disease, obesity, diabetes, or smoking, will need more frequent testing. Your specialist will provide personalised advice based on your individual circumstances.