What is high cholesterol?
High cholesterol means raised levels of low-density lipoprotein (LDL) cholesterol in the blood, which gradually builds up in artery walls and increases the risk of heart attack and stroke. It is extremely common and usually results from a mix of genetics, diet, weight and inactivity. A minority of people have familial hypercholesterolaemia, an inherited condition causing very high levels from birth that runs strongly in families and warrants earlier, more intensive treatment.
High cholesterol causes no symptoms, so it is detected with a blood test — often at an NHS Health Check or before starting blood pressure treatment. Doctors interpret the result alongside your overall cardiovascular risk, calculated from age, blood pressure, smoking and other factors, rather than treating the number in isolation.
Common symptoms
- No symptoms in almost all cases
- Detected on a routine blood test
- Tendon or skin cholesterol deposits (familial cases only)
- A pale ring around the iris at a young age (familial cases only)
- Family history of early heart attacks may be the only clue
- Symptoms only appear if complications such as angina develop
How long will you wait?
Cholesterol testing and statin treatment happen quickly through GPs, but referral to a specialist lipid clinic — for suspected familial hypercholesterolaemia or statin intolerance — typically waits several months in much of England.
Privately, you can typically see a consultant within 3–7 days, with a full lipid profile and any cardiac risk assessment, such as a calcium score, completed within 1–2 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Diet and lifestyle changes. Reducing saturated fat, eating more fibre, exercising and losing weight can lower cholesterol by a worthwhile margin.
- Statins. First-line, well-evidenced tablets that lower LDL cholesterol substantially and reduce heart attack and stroke risk.
- Ezetimibe. A tablet that reduces cholesterol absorption, used alongside or instead of statins when needed.
- Injectable therapies. PCSK9 inhibitors and inclisiran offer powerful LDL lowering for high-risk patients or those who cannot tolerate statins.
What does private treatment cost?
As a guide, a private consultation with full lipid profile typically costs £300–£500, with a coronary artery calcium score scan around £300–£500 if risk needs clarifying.
Does health insurance cover high cholesterol?
Be aware that high cholesterol is treated as a chronic condition by UK private medical insurers: ongoing statin prescriptions, monitoring blood tests and routine reviews are not covered and remain with your GP. PMI may fund initial specialist assessment or investigations if concern arises after your policy starts — for example, a cardiology work-up for chest pain. Cholesterol noted before joining is usually excluded as pre-existing.
Frequently asked questions
What cholesterol level is considered high?
As a general guide, UK clinicians like total cholesterol below 5 mmol/L and LDL below 3 mmol/L for healthy adults, with lower targets for people with existing heart disease or diabetes. But context matters more than the raw figure: treatment decisions rest on your overall cardiovascular risk, combining cholesterol with age, blood pressure, smoking and family history. Ask for your full breakdown, including the LDL and HDL split.
Are statins safe to take long term?
For the great majority, yes. Statins are among the most studied medicines in existence, and serious side effects are rare. Muscle aches are reported fairly often, though blinded trials suggest most such symptoms are not actually caused by the statin; switching statin or dose usually resolves genuine cases. For people at raised cardiovascular risk, the protection against heart attack and stroke clearly outweighs the risks.
Can I lower my cholesterol without medication?
You can make a real difference: cutting saturated fat, eating oats, nuts, and plant sterols, increasing exercise and losing weight can lower LDL by around 10–20% combined. Whether that is enough depends on your starting level and overall risk. People with familial hypercholesterolaemia or existing cardiovascular disease will almost always need medication as well — lifestyle and tablets work best together, not as alternatives.
Related guides
- Angina
- Atrial Fibrillation
- Heart Palpitations
- Heart Valve Disease
- High Blood Pressure (Hypertension)