cholesterol and family life

Overview

Cholesterol is a waxy, fat-like substance found in every cell of your body. Your body needs it to build healthy cells and make hormones. But when you have too much cholesterol in your blood, it can stick to the walls of your arteries and narrow them, which raises your risk of heart disease and stroke.

Yes. High cholesterol is very common worldwide. In the UK, around 2 in 5 adults have high cholesterol, and many don't know it.

High cholesterol can affect people of all ages, including children. It is more likely as you get older, and it can be passed down in families. People with a family history of heart disease, high blood pressure, or diabetes are especially at risk.

Symptoms

Common symptoms

• High cholesterol on its own usually has no symptoms.
• If it narrows arteries over time, you might feel chest pain, leg pain when walking, or shortness of breath — but this is usually after the damage has built up.

Symptoms in children

• Children with inherited high cholesterol usually have no symptoms at all.
• Sometimes, fatty lumps may appear under the skin, especially around the knuckles, elbows, or knees.

Symptoms in older adults

• Older adults often have no symptoms, but may experience symptoms of reduced blood flow, such as chest pain, dizziness, or calf cramps during activity.

Causes

Main causes

• A diet high in saturated fats and trans fats, found in fried foods, processed snacks, and fatty meats
• Lack of regular physical activity
• Smoking, which can damage blood vessels and lower 'good' cholesterol
• Genetics — a condition called familial hypercholesterolaemia can cause very high cholesterol from a young age

Risk factors

• Having a parent, sibling, or other close relative with high cholesterol or early heart disease
• Being over 40 years old
• Having high blood pressure, diabetes, or being overweight
• Being male, or female after menopause

When to see a doctor

See a doctor urgently if:

• If you or a family member has chest pain, shortness of breath, or signs of a stroke, call your local emergency number immediately.

Book a routine appointment if:

• Ask your doctor about a cholesterol test if you are over 40.
• If you have a family history of high cholesterol or early heart disease, ask about testing earlier — even if you feel well.
• Make an appointment if you are worried about your heart health or want help with diet and exercise changes.

Diagnosis

High cholesterol is diagnosed with a simple blood test. It may be a finger-prick test or a blood draw from your arm. The test measures different types of cholesterol and fats in your blood.

Tests that may be done

• Total cholesterol — the overall amount of cholesterol in your blood
• LDL cholesterol — sometimes called 'bad' cholesterol, which can build up in arteries
• HDL cholesterol — sometimes called 'good' cholesterol, which helps carry cholesterol away
• Triglycerides — another type of blood fat

What to expect at your appointment

Your doctor may ask you to fast (avoid food and drink except water) for several hours before the test. The test itself is quick and usually painless. You'll get results within a few days, and your doctor will explain what they mean for your health.

Treatment

Treatment for high cholesterol usually starts with lifestyle changes that the whole family can join in with. If that isn't enough, your doctor may recommend medication. The goal is to lower your cholesterol and reduce your risk of heart attack and stroke.

Self-care at home

• Eat more fruit, vegetables, whole grains, beans, and nuts.
• Limit foods high in saturated fat, such as fried foods, pies, pastries, and fatty cuts of meat.
• Swap butter and lard for healthier oils like olive or rapeseed oil.
• Aim for at least 150 minutes of moderate activity each week — brisk walking, cycling, or dancing all count.
• If you smoke, ask your healthcare team for support to quit.

Medical treatments

Your doctor can prescribe medicines that help lower cholesterol by reducing how much cholesterol your liver makes or by helping your body remove it from your blood. The most common type is called a statin, but there are other options if you can't take one. Your doctor will explain the benefits and possible side effects before you start.

When is surgery considered?

Surgery is not needed for high cholesterol itself. However, if cholesterol has already caused narrowed or blocked arteries, you may need a procedure to open them, such as an angioplasty or bypass surgery. Your cardiologist will discuss this if it becomes necessary.

Living with this condition

Living with high cholesterol means making heart-healthy habits part of your family's daily life. You can cook together, go for walks after meals, and read food labels as a team. Small, consistent changes make a big difference.

Lifestyle tips

• Plan meals around vegetables, fruit, and whole grains.
• Check nutrition labels for saturated fat — aim for products with 1.5g or less per 100g.
• Limit sugary drinks and processed snacks.
• Make movement fun — family bike rides, swimming, or playing in the park.
• Manage stress with talking, breathing exercises, or quiet time together.

Diet and exercise

A heart-healthy diet includes plenty of plant foods, lean proteins like fish and chicken (without skin), and low-fat dairy. Use oils instead of butter, and eat oily fish like salmon or mackerel a couple of times a week. Combined with regular exercise, these changes can lower cholesterol and improve energy levels.

Mental health and emotional wellbeing

Finding out you or a family member has high cholesterol can feel worrying. Some people feel anxious or guilty, but high cholesterol can affect anyone, and genes play a big role. It's important to talk about your feelings and support each other as a family rather than blaming anyone.

Prevention

In many cases, high cholesterol can be prevented or improved with a healthy lifestyle. Regular exercise, a balanced diet, and not smoking all help. If you have a strong family history, you may still develop high cholesterol even with healthy habits, but regular testing can catch it early.

Screening programmes

Adults can get a cholesterol test as part of an NHS health check. Children may be tested if there is a family history of inherited high cholesterol or early heart disease.

Complications

If left untreated

• Narrowing of the arteries (atherosclerosis), which can restrict blood flow
• Heart attack, if a coronary artery becomes blocked
• Stroke, if blood flow to the brain is blocked
• Peripheral artery disease, causing leg pain and poor circulation

Long-term outlook

The outlook is usually very positive. With lifestyle changes, support, and treatment if needed, you can lower your cholesterol and protect your heart. Many people live long, active, and healthy lives by working with their healthcare team and making small, lasting changes.

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