A GP has explained what cholesterol results can and cannot tell you about your heart health, warning that the numbers may not always reveal the full picture.
Dr Vik Vasishta, Medical Director at Vista Health and NHS GP, has detailed what cholesterol results mean and when it may be appropriate to seek further advice. Cholesterol is a fatty substance found naturally in the blood. While the body needs cholesterol to function, high levels can narrow arteries and cause fatty material to build up, increasing the risk of a heart attack or stroke.
According to the British Heart Foundation, more than twice as many women in the UK die from heart disease each year as from breast cancer, yet heart disease is still often seen as a men's health issue.
What a high result can indicate
Dr Vik Vasishta said: "Knowing your cholesterol levels can provide valuable insights into your cardiovascular risk, but they should also be viewed in conjunction with the full clinical picture. Risk factors help to identify those at a higher risk of cardiovascular disease, while appropriate imaging can help identify whether a heart condition is already present and whether earlier intervention may be beneficial."
High cholesterol can contribute to fatty deposits building inside the arteries, increasing the risk of heart attack and stroke. As a general guide for healthy adults, total cholesterol should be below 5 mmol/L and non-HDL cholesterol (artery blocking fats) below 4 mmol/L.
What it cannot confirm
Raised cholesterol can indicate a higher risk of heart disease, but it cannot tell you whether narrowing or blockages have already developed in the arteries supplying your heart, a condition known as coronary artery disease.
Cholesterol results should be assessed alongside factors such as blood pressure, blood glucose, age, family history, smoking status, and wider health. The pattern of results over time can also be more useful than one individual reading, Dr Vik Vasishta said.
When to speak to a healthcare professional
Dr Vik Vasishta said: "Risk factors can tell us what may affect our health in the future, while appropriate assessment can help us understand what may already be happening. This distinction became particularly important for one of my patients, who had persistently high cholesterol for several years."
One of his patients had experienced high cholesterol for several years. Although this was being monitored, further tests were needed to check whether narrowing or blockages had developed in the arteries supplying her heart. She underwent a CT calcium score, a non-invasive scan that checks for calcium build-up in the heart arteries. Her results showed that she was at very high risk of heart disease.
This led to a CT coronary angiogram, which takes detailed images of the heart and its arteries. The scan confirmed significant narrowing and blockages, and the patient has since received potentially life-saving treatment.
Dr Vik Vasishta said: "This case shows that risk factors tell us about probability, but appropriate assessment can help identify whether disease is already present. If your results remain raised, you have several cardiovascular risk factors or a family history of heart disease, speak to a healthcare professional about the appropriate next step. This will not mean further testing is necessary for everyone, but it can help you make an informed decision about your heart health."
