Cholesterol: What To Do
Fat-like substances carried in the blood by lipoproteins, reported as several fractions.
Last revised
Total cholesterol alone is close to meaningless; the split between LDL and HDL, and your overall risk, is what a decision rests on.
Key takeaways
- Total cholesterol, commonly quoted target: 5mmol/L or below
- Non-HDL, commonly quoted target: below 4mmol/L
- Most useful single change: Ask for your non-HDL figure and your ten-year risk score, not just the total.
- Commonest mistake: Judging your result on total cholesterol alone.
- See a doctor if any of the signs under "When to get help" below apply to you.
Do
- Ask for your non-HDL figure and your ten-year risk score, not just the total
- Replace saturated fat with unsaturated fat rather than refined carbohydrate
- Increase soluble fibre from oats, beans and fruit
- Mention any family history of heart disease before age 60
Do not
- Judging your result on total cholesterol alone
- Stopping a statin without discussing it with your GP
- Assuming diet alone can normalise very high inherited levels
The figures behind the list
Each item above follows from these, published in the guidance named at the foot of the page.
| Measure | Figure |
|---|---|
| Total cholesterol, commonly quoted target | 5mmol/L or below |
| Non-HDL, commonly quoted target | below 4mmol/L |
| HDL, men | above 1.0mmol/L; women above 1.2mmol/L |
| Fasting required | usually not |
| Familial hypercholesterolaemia prevalence | roughly 1 in 250 |
Where to go next
- Cholesterol: Sorting the Evidence From the Noise
- Cholesterol, Explained Without the Jargon
- Cholesterol — the reference entry
- What the Guidance Really Says About Cardiovascular Risk
- Smoking and the Heart: What Published Guidance Supports
When to get help
See a GP if you have a family history of heart attack or stroke before 60, or fatty deposits around the eyes or in tendons. Call 999 for chest pain or tightness lasting more than a few minutes, pain spreading to the arm, neck or jaw, or sudden breathlessness with sweating.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.