High cholesterol living in older adults

Overview

High cholesterol means having too much of a fatty substance called cholesterol in your blood. Over time, this can build up in your arteries (the tubes that carry blood from your heart to the rest of your body) and make them narrow or block them. It is common in older adults and often has no symptoms until a problem occurs.

Yes, high cholesterol affects about 2 in 5 adults over 65 in the UK. It becomes more common as people age.

It affects all older adults, but is more likely in those who have a family history of high cholesterol, eat a diet high in saturated fats, are overweight, or have certain medical conditions like diabetes or an underactive thyroid.

Symptoms

Common symptoms

• High cholesterol usually has no symptoms. You might only know you have it after a blood test.

Symptoms in older adults

• No symptoms until complications like chest pain (angina), leg pain when walking, or stroke symptoms occur.

Causes

Main causes

• Your body makes cholesterol naturally, but too much can come from eating foods high in saturated fats (like fatty meats, butter, and full-fat dairy) or trans fats (like some fried and processed foods).
• Genetics can also cause high cholesterol, even if you eat well.
• As you age, your body’s ability to clear cholesterol from the blood may slow down.

Risk factors

• Being overweight or obese
• Eating a diet high in saturated and trans fats
• Not getting enough physical activity
• Smoking or using tobacco
• Having diabetes, high blood pressure, or a family history of early heart disease

When to see a doctor

See a doctor urgently if:

• If you have chest pain, shortness of breath, or sudden weakness — call your local emergency number immediately.

Book a routine appointment if:

• If you are 40 or older, you are eligible for a free NHS health check that includes a cholesterol test.
• Speak to your GP if you have a family history of high cholesterol or heart disease.
• If you have diabetes, high blood pressure, or other risk factors, your doctor may check your cholesterol regularly.

Diagnosis

High cholesterol is diagnosed with a simple blood test called a lipid profile. You may be asked to fast (not eat) for about 12 hours before the test, though many tests now don't require it.

Tests that may be done

• Lipid profile (blood test) — measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides.

What to expect at your appointment

The test takes a few minutes. Your doctor will explain your results and what they mean for your health. They may repeat the test if levels are high.

Treatment

Treatment focuses on lowering your cholesterol to reduce the risk of heart attack and stroke. Your doctor will help you decide the best approach based on your overall health and cholesterol levels.

Self-care at home

• Eat a heart‑healthy diet — more fruits, vegetables, whole grains, and lean proteins, and less saturated fat.
• Stay physically active — aim for at least 150 minutes of moderate activity each week, like brisk walking or swimming.
• Keep a healthy weight — losing even 5‑10% of your body weight can help.
• Quit smoking and limit alcohol.

Medical treatments

If lifestyle changes alone aren't enough, your doctor may suggest a type of medicine called a statin, which helps lower cholesterol. There are also other medicines that work in different ways. Your doctor will discuss the benefits and possible side effects before starting any treatment. Never take cholesterol medicine without a prescription.

When is surgery considered?

Surgery is not used for high cholesterol itself, but you may need a procedure like angioplasty or bypass surgery if cholesterol build-up has already caused severe blockages in your arteries.

Living with this condition

Managing high cholesterol is mostly about daily habits — eating well, staying active, and taking any medicines as prescribed. You can still enjoy a wide variety of foods; small changes often make a big difference.

Lifestyle tips

• Cook with vegetable oils instead of butter or lard.
• Choose lean meats like chicken or fish, and trim visible fat.
• Use wholemeal bread, pasta, or rice instead of white versions.
• Snack on unsalted nuts, fruit, or vegetables.

Diet and exercise

A balanced diet low in saturated fats and regular exercise can lower your cholesterol. Try to be active most days — even a 20‑minute walk helps. Talk to your doctor before starting a new exercise programme.

Mental health and emotional wellbeing

Living with a long-term condition can feel worrying, but high cholesterol is manageable. If you feel anxious or stressed, talk to your doctor or a counsellor. Some people find joining a support group helpful.

Prevention

You cannot prevent high cholesterol entirely — especially if it runs in your family — but you can lower your risk with a healthy diet, regular activity, and not smoking. These steps also help control blood pressure and weight.

Screening programmes

In England, all adults aged 40 to 74 are offered an NHS Health Check every 5 years, which includes a cholesterol test. If you are younger and have risk factors, ask your doctor for a test.

Complications

If left untreated

• Heart attack — when a coronary artery becomes completely blocked.
• Stroke — blood flow to part of the brain is blocked or interrupted.
• Peripheral arterial disease — narrowed arteries in the legs causing pain and poor circulation.

Long-term outlook

High cholesterol can be very well managed. With the right combination of lifestyle changes and, if needed, medication, many people live full, active lives without heart problems. The key is to get tested and act early.

Find support

Local organisations

• British Heart Foundation (BHF) · UK

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