Abnormal amount of lipids (different types of ‘fats’) in the blood.

‘Fats’ circulate in different forms in the body, the ‘bad lipids’ include triglycerides and LDL, and the ‘good lipids’ include HDL.

A high amount of bad lipids in the circulation can cause an accumulation of fatty plaque inside the walls of the arteries which leads to progressive narrowing and increases the risk of a heart attack and stroke.

In some patients the high cholesterol is hereditary. This means that there is a genetic mutation that causes a high amount of circulating bad cholesterol. These patients are at much higher risk of heart attacks and strokes, and generally require treatment at a younger age.

There are no specific symptoms of high cholesterol, however in some people a build up of cholesterol may be noted in the eyes, around the eyes (yellow plaques), or in the tendons of the hands and feet.

Treatment is individualised according to the patient’s risk of a heart attack/stroke. There are various calculators that can be used to calculate a patients 5 or 10 year risk.

For patients at high risk, or who fail to control their cholesterol with lifestyle modifications, then medications are indicated, the most commonly prescribed agent is a statin, but there are other medications that can also be useful.

Lifestyle modifications are essential:

• • Healthy eating (Mediterranean diet), especially in order to lose weight if your BMI is >25
  • Salt restriction (less than 4g daily)
  • Limitation of alcohol intake (no more than two standard drinks a day for men and one for women, with at least 2 alcohol-free days a week)
  • At least 30 minutes of moderate intensity exercise daily
  • Avoidance of smoking