High cholesterol

London Medical provides expert analysis of your cholesterol levels and helps you protect your heart health

Heart and circulatory diseases are one of the UK’s biggest killers, causing a death every 3 minutes. Raised cholesterol levels are associated with an increased risk of developing cardiovascular disease but they are only one of many risk factors. What are these risk factors? What is their relative importance? And how can you find out more about them? In most cases, all you will be armed with is a total cholesterol level in your blood and your family history.

High Cholesterol

High cholesterol is not associated with any immediate ill health or symptoms. Sometimes patients with one of the familial inherited syndromes may have noticed fatty lumps around the eyes, knuckles or heels. 80% of those who suffer a heart attack have the same cholesterol level as those with no heart disease. More than 50% of heart disease will be missed by standard screening tests using just total and HDL cholesterol. So it is important for you to enquire on your risk of arterial disease in addition to knowing your cholesterol number. This is particularly important if you also have diabetes or are smoking cigarettes. You

can now be treated before a heart attack to reverse the arterial thickening that characterizes this disease and there is increasing evidence that intense reduction of LDL cholesterol is life saving in patients with high risks for a cardiovascular event.

What causes high cholesterol?

Anyone can have high cholesterol; however, your lifestyle, your family history and your health can all affect your chances of having raised levels. Factors that increase the risk include:

A diet high in saturated fat
An inactive lifestyle
High levels of body fat, especially if it’s located around the waistline
Smoking
Being overweight or obese
Increasing age
Being of South Asian or Afro-Caribbean ethnicity
Family history of Familial Hypercholesterolaemia
Diabetes
Liver or kidney disease
Underactive thyroid gland

Although you cannot change your genetic heritage or your age, there are many ways of reducing your cholesterol and your chance of having a heart attack.

London Medical’s cardiac consultants are world-leaders in heart disease prevention. They will work to control any chronic conditions, support you in making lifestyle changes and target treatment to improve your cholesterol profile.

Are you, or someone you know, at risk of heart disease?

This is something that we all contemplate at some time or another. However, if we have been unlucky enough to experience the sudden loss of a work colleague from a heart attack or a close relative or friend has had to have a heart operation or angioplasty, it suddenly makes it all the more real. Whether it is a personal concern or a corporate issue, wouldn’t it be reassuring to know that you can protect your most valuable asset?

Who is Likely to Need a Heart and Cholesterol Check?

You are at particular risk if you have
suffered a heart attack, stroke, TIA, or been treated with a stent or have angina
erectile dysfunction
diabetes or high blood pressure
claudication (pains in the legs on exercise)
a family history of cardiovascular disease
a history of smoking
an increasing waistline

Did You Know?

There are four types of factors that determine your risk of heart disease

Fixed Risk - your genes (your family history), age, ethnicity
Medical – diabetes, high blood pressure, insulin resistance, peripheral arterial disease, chronic infections
Treatable – lipoprotein abnormalities, homocysteine, insulin resistance, raised triglyceride
Lifestyle factors – smoking, weight control, exercise, stress

When heart attack runs in your family

Many patients consult us for preventive care because they have relatives who have suffered heart attacks or strokes, often early in life. Inheritance is most important when relatives develop angina or a heart attack earlier in life. London Medical has a lipid clinic specialising in the care of people who have inherited one of the gene abnormalities leading to a very high cholesterol, familial hyperlipidaemia, using intense LDL cholesterol reduction to minimise the arterial diseases these patients can get at an early age. Others seek advice after they themselves develop such illnesses or other cardiovascular diseases, including arterial disease in the legs, in order to reduce the risk of a recurrence. Further patients are referred because their blood tests have revealed high cholesterol levels or high levels of triglyceride (blood fat); some of them have responded inadequately to treatment or have experienced side effects of drug therapy.

What is special about the cholesterol and heart disease prevention service at London Medical?

We first investigate your risk as your treatment needs to be tailored to the extent of your arterial disease and the threat of an early cardiovascular event. We do this using a combination of advanced lipoprotein analysis using nuclear magnetic resonance spectroscopy (NMR) to obtain particle numbers of total LDL and HDL cholesterol and the particularly atherogenic small dense LDL particle numbers as well as the increasingly important lipoprotein (a) particle numbers. Inflammatory markers include the high sensitivity CRP, the myeloperoxidase and the Lp-PLA2. We use Europe’s first 3D ultrasound probe to quantify the volume of plaques seen in the common carotid arteries and define the intima media thickness, a measurement we pioneered in the UK and which is the gold standard for assessing the progression or regression of atherosclerosis with time. We also get information from the coronary artery calcification score. Using this information, and with the help of specialist dietitians, a full array of cardiac tests, expert consultant cardiologists, vascular surgeons, diabetes consultants, and fantastic new drugs for lowering cholesterol including the PCSK9 inhibitors, we can demonstrate regression and improvement in the cardiovascular outlook for many of our patients at high risk. Patients who have difficulty or side effects taking statins have access to expertise for gene testing and alternative therapy. Treatment to reduce the risk of heart disease needs to be formulated specifically to an individual’s metabolic status.

We get quantitative measures of risk using imaging with a unique intima media and 3D plaque carotid ultrasound study and the coronary artery calcification score. We then integrate this information, including rates of progression or regression of atherosclerosis using regular data from monitoring, with family history, smoking history, menopausal status, weight, blood pressure and the presence or risk of diabetes to help arrive at a treatment recommendation more appropriately linked to risk.

Frequently Asked Questions

How often should my cholesterol be tested?

If you are taking medications to reduce your cholesterol, your lipid profile should be tested every year to monitor your health and ensure the treatment is effective.

What are the side-effects of statins?

All medicines have potential side effects, however statins have been widely used and studied and are generally very safe. The most common complication is muscular aches and pains, which can be uncomfortable but are not dangerous.

In rare cases, statins may increase the risk of developing type 2 diabetes. If you have side effects or you have any concerns about your treatment, please speak to your consultant or the pharmacy team at London Medical.

Will I need blood tests when taking statins?

What diet can lower my cholesterol?

Research suggests that a Mediterranean-style diet may protect your heart and keep you healthy. It’s low in meat, dairy and saturated fats to reduce cholesterol. Meals are rich in fresh fruit and vegetables, wholegrain cereals, beans and pulses and healthy fats like olive oil, oily fish and avocado. Make an appointment with the specialist dieticians at London Medical for advice, support and a personalised nutrition plan.

However, although cholesterol is present in foods, a change in your diet can only reduce your cholesterol by around 5%. If tests show that your LDL cholesterol is raised, you are likely to need medication, even if you eat a healthy diet and a live an active life.

Our Specialist Cardiologists

Dr George Amin-Youssef

Heart failure, valve and coronary artery disease, echo cardiograph. Exercise and stress echocardiography.

Professor Thomas F. Lüscher

Cardiology (from Prevention to Intervention)

Professor Carlo Di Mario

Director Structural Interventional Cardiology University of Florence & Honorary Consultant Cardiologist Royal Brompton Hospital London

Dr Fadi Jouhra

Consultant Cardiologist in Heart Failure and Complex Devices at St George’s University Hospitals NHS Foundation Trust.

Dr Simon Woldman

Dr Woldman is the chairman of the North Central London Heart Failure task group.

Our cholesterol clinic is based in the heart of London

London Underground
The clinic is within walking distance of Baker Street and Regent’s Park tube stations, serving the Bakerloo, Circle, Hammersmith & City and Metropolitan lines.

Parking
Parking is available in Beaumont Street and behind Waitrose. Alternatively, metered parking may be found in the immediate vicinity.

London Medical is located within the London Congestion Charge Zone.

How to get here