Cholesterol

What usually happens

It causes no symptoms. You cannot feel high cholesterol and you will not know it from how well you feel — which is why it is found on a blood test rather than by noticing something.

The number alone does not decide anything. What matters is your overall risk over the coming years — age, blood pressure, smoking, diabetes, family history and the numbers together. That is why two people with the same cholesterol can be given genuinely different advice, and it is not inconsistency.

It is a long game. This is about preventing something years away, not fixing something today, which is what makes it easy to put off and worth not putting off.

Diet and activity matter and are often not enough on their own, particularly where the driver is inherited. Needing medication is not a sign you failed at the lifestyle part.

At your appointment

We will look at the whole picture rather than one number — your other conditions, your blood pressure, whether you smoke, and your family history, especially heart disease early in a parent or sibling.

We will usually calculate your risk over the next ten years. It is an estimate, not a prophecy, and it is there to make the size of the decision visible.

If treatment makes sense we will discuss what it does and does not do, and agree when to recheck. If it does not yet, we will agree when to look again.

Worth asking

• —What is my actual risk, and what would treatment change about it?
• —Is my family history relevant here?
• —What would you expect from diet and exercise in my case — realistically?
• —If I start something, how long am I on it, and when do we recheck?