Cholesterol is a fat that all humans have in their bodies. We need cholesterol as it is improtant for maintaining the the cells that make up our bodies as well as being used to make different substances in the body.

Despite the human body needing cholesterol for healthy functioning it is also involved in some damaging processes also. The main issue is that cholesterol is involved in a process of narrowing of the blood vessels in the body. this is call atherosclerosis.

This is sometimes described as 'furring up' of the blood vessels. One way to think about this is like the pipes you have under your sink. When they are first put in they are clean and water flows through them without any problem. If you but fats down the sink some of this will stick to the side of the pipes causing them to narrow. To begin with you wont notice any problems and the water will still flow normally. As more fat sticks to the side of the pipes, however, you will notice the water takes longer to drain away. Eventually you may find the water doesn't drain at all as the pipe has completely blocked.

With high cholesterol you are at a higher risk of this narrowing of the blood vessels in your body. To begin with you will probably not notice any problems or symptoms. If the narrowing gets worse, however, you might start to develop symptoms. This is becuae it can reduce the blood flow to parts of your body. If the blood flow to your heart is reduced you can get angina. If the blood flow to your legs is reduced you can get pain.

If this worsens and the blood vessels get even narrower the amount of blood getting to certain parts of the body can be so low that they can't survive. This is what happens in a heart attack and most forms of strokes. The blood supply to the heart or brain is stopped due to a blockage of a blood vessel and the heart or brain looses it's supply of oxygen and so can't function.

Obviously we want to avoid patients having heart attacks and stokes so we have to try and make changes to reduce the risk of these well before this narrowing occurs. This means that we often look to give advice about reducing cholesterol and starting people on medication before they develop any symptoms.

We get cholesterol through our diet and some is also made by the body.

Usually high cholesterol is caused by eating fatty food, not exercising enough, being overweight, smoking and drinking alcohol.

high cholesterol can also run in families.

By changing your diet, increasing exercise, losing weight, stopping smoking and reducing alcohol you can reduce your cholesterol

Some people, however, will continue to have a high cholesterol even with a perfect diet and lifestyle and so we also need to look at starting people on medication to help reduce their cholesterol.

The NHS website has some advice on how you can lower your cholesterol without the use of medication. Please click on the link below for more information

How To Lower Cholesterol

A lot of people have heard of statins. They are a very good drug to reduce cholesterol.

Not everyone is advised to start a stain and we base this on several factors.

It is recommended that all diabetic patients are put on a statin as they are at a higher risk of heart disease and stroke due to their diabetes.

Patients who have knon heart disease, vessel disease, or who have had a TIA or stroke will also all be advised to have a statin. This is becuase we know they will already have narrowing of their blood vessels so we have to try and stop this from worsening.

For everyone else we base the deicison to start satins on the individual patient's risk of having a heart attack or stroke.

Cholesterol is not the only risk factor for heart attacks or strokes. Other risk factors include smoking, being male, increasing age, and high blood pressure. We can use this information to calculate the risk of a patient having a heart attack or stoke in the next 10 years.

If a patient's risk of a heart attack or stroke in the next 10 years is over 10% a statin is recommended. 

As mentioned above we get cholesterol from our diet but it is also made by our bodies. Statins reduce the amount of cholesterol the body makes.

Most people who take statins get no side effects.

For every 100 patients taking a statin:

• 1-10 will gets some muscle pains. 
• 1 will get a change to their liver tests

Often patients who get side effects from one statin can be changed to a different one that suits them better. The aim is to find a statin that reduces cholesterol but doesn't give the patient any side effects

Depending on your risk of developing a heart attack over the next 10 years the following links will show you how many heart attacks can be prevented by starting a statin.