Understanding Each Component
| Component | What It Means | Target |
|---|---|---|
| Total cholesterol | Sum of all cholesterol types | <5.0 mmol/L (general population) |
| LDL (low-density lipoprotein) | 'Bad' cholesterol — deposits in artery walls | <3.0 mmol/L (general); <1.8 mmol/L (very high risk) |
| HDL (high-density lipoprotein) | 'Good' cholesterol — removes cholesterol from arteries | Higher is better; >1.0 mmol/L (men), >1.2 mmol/L (women) |
| Triglycerides | Blood fats related to diet and metabolic health | <1.7 mmol/L |
| Non-HDL cholesterol | Total minus HDL — increasingly used as primary target | <4.0 mmol/L (general) |
Familial Hypercholesterolaemia — When Genetics Matter
About 1 in 250 people have familial hypercholesterolaemia, a genetic condition causing very high LDL cholesterol from birth and significantly increased early heart disease risk. Clues include: total cholesterol >7.5 mmol/L, family history of early heart attacks, or physical signs like tendon xanthomas (cholesterol deposits). This requires specialist referral and often statin treatment from a young age.Lifestyle vs Medication
| Approach | Typical LDL Reduction |
|---|---|
| Diet changes (Mediterranean, reduced saturated fat) | 10-20% |
| Weight loss (if overweight) | 5-10% |
| Exercise | Modest LDL effect; more effect on HDL and triglycerides |
| Statins (standard dose) | 30-50% |
| Statins (high dose) + ezetimibe | Up to 65-70% |
| PCSK9 inhibitors (injectable) | Additional 50-60% on top of statins — for very high risk |
Your Overall Risk Matters More Than a Single NumberCholesterol targets are increasingly individualised based on your overall cardiovascular risk (calculated using tools like QRISK3) rather than a one-size-fits-all number — someone with diabetes or existing heart disease needs much lower LDL targets than someone with no other risk factors.
Is high HDL always good?
Generally yes, but extremely high HDL (>2.3 mmol/L) has been associated with some unexpected outcomes in certain studies — the relationship isn't perfectly linear, though moderate-high HDL remains protective for most people.
Do eggs raise cholesterol?
For most people, dietary cholesterol (from eggs, shellfish) has a smaller effect on blood cholesterol than saturated and trans fats — moderate egg consumption is not significantly harmful for most people.
Can cholesterol be too low?
Extremely low cholesterol is rare and usually only seen with certain medical conditions or very restrictive diets/malabsorption — for most people on statins, lower is better within recommended treatment ranges.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.