A cardiologist has highlighted that feeling fit and well does not necessarily mean your heart is fully protected, and has outlined straightforward steps that could help reduce cardiovascular risk. High cholesterol frequently presents no symptoms, meaning the only way to determine your levels is through a blood test. Understanding the results, and what they mean alongside other risk factors, can be a vital step towards preventing future heart complications.
October marks National Cholesterol Month, with HEART UK running its 2026 campaign under the message 'Cholesterol Matters. Every Swap Counts'. The campaign encourages people to understand their cholesterol and make practical changes to protect their heart health.
Know your cholesterol number
Dr Francesco Lo Monaco, a preventative cardiologist and founder of The National Heart Clinic on London's Harley Street, explained why knowing your numbers matters. He is also the author of Heart Saviour, a new book designed to show how small, consistent changes can make life-changing differences to health and longevity.
Dr Lo Monaco said: "One of the challenges with high cholesterol is that people can feel completely well and assume everything is fine. But cholesterol doesn't usually cause symptoms you can feel, so you cannot judge your cardiovascular health simply by how healthy you feel. Knowing your cholesterol levels gives you useful information, but the important thing is understanding what those numbers mean for your individual risk."
What do your cholesterol numbers actually mean?
A cholesterol test, commonly referred to as a lipid profile, measures various fats present in your blood. Results may include total cholesterol, HDL cholesterol, non-HDL cholesterol and triglycerides. HDL is frequently described as 'good' cholesterol because it assists in transporting cholesterol back to the liver. Non-HDL cholesterol encompasses the cholesterol carried by particles that can contribute to fatty deposits in artery walls.
For healthy adults, a total cholesterol level below 5mmol/L and non-HDL cholesterol at or below 4mmol/L are widely used as general UK guideline levels. However, these figures do not provide a complete assessment of an individual's cardiovascular risk, and personal targets may vary.
Dr Lo Monaco said: "It's important not to focus on just one number in isolation. Your clinician will consider your cholesterol results alongside factors such as your blood pressure, age, smoking status, diabetes, medical history and whether you have a family history of cardiovascular disease. That wider picture helps determine what action, if any, is needed."
Why cholesterol is essential
Cholesterol plays a vital role in the body, assisting in cell construction and the production of hormones, including oestrogen, testosterone and cortisol. "Cholesterol itself isn't bad," Dr Lo Monaco said. "The concern is when certain cholesterol-carrying particles become too high, increasing cardiovascular risk."
Dr Lo Monaco drew attention to two further markers that may assist clinicians in evaluating cardiovascular risk in suitable patients: ApoB and Lp(a). He said: "ApoB measures potentially harmful cholesterol-carrying particles, while Lp(a) is largely genetically determined and can increase heart disease risk even when standard cholesterol levels appear normal." Whether these tests are appropriate depends on an individual's circumstances and should be discussed with a healthcare professional.
Five ways to support healthier cholesterol levels
There are practical measures people can adopt to support their cardiovascular wellbeing.
- Swap some saturated fats for unsaturated fats: Swapping foods high in saturated fat for sources of unsaturated fat, such as olive oil, nuts, seeds and oily fish, can help improve cholesterol levels.
- Eat more fibre-rich foods: Beans, lentils, fruit and vegetables provide fibre, while oats and other foods containing soluble fibre can help lower LDL cholesterol.
- Move more regularly: Regular physical activity supports cardiovascular health and can help improve some blood-fat measurements. Walking, cycling, swimming and other activities you enjoy can all contribute.
- Avoid smoking: Smoking damages blood vessels and increases cardiovascular risk. Stopping smoking is one of the most important steps people can take to protect their heart health.
- Know when lifestyle changes aren't enough: Healthy habits can make a meaningful difference, but genetics and other medical factors also influence cholesterol. Some people will need medication, such as statins, alongside lifestyle changes to reduce their risk.
Dr Lo Monaco said: "There is no single food, supplement or lifestyle change that can guarantee protection from heart disease. The most effective approach is to understand your own risk, make sustainable changes and seek medical advice when needed. If you have high cholesterol, don't assume that improving your diet alone will always be sufficient - treatment decisions should be based on your overall cardiovascular risk."
Why it's worth checking now
Those who have not had their cholesterol checked, or are uncertain about what their results mean, are encouraged to speak to their GP or healthcare professional about testing and their individual cardiovascular risk. For Dr Lo Monaco, this emphasis on prevention lies at the heart of both his work at The National Heart Clinic and the ethos behind Heart Saviour: that small, consistent lifestyle changes can make a genuinely significant difference to long-term health.
"Prevention is about identifying risks before they develop into serious problems," he said. "You don't need to wait until you feel unwell to start taking your heart health seriously."
