Cholesterol is a waxy substance found in your blood. While your body needs cholesterol to build healthy cells, high levels of certain types of cholesterol can increase your risk of cardiovascular disease. Heart disease remains the leading cause of death in the UAE, making cholesterol management a critical health priority.
Types of Cholesterol
LDL Cholesterol ("Bad" Cholesterol)
Low-density lipoprotein carries cholesterol to your arteries. High LDL levels cause plaque buildup (atherosclerosis), narrowing arteries and increasing the risk of heart attack and stroke.
HDL Cholesterol ("Good" Cholesterol)
High-density lipoprotein carries cholesterol away from your arteries back to the liver, where it is broken down. Higher HDL levels are associated with lower cardiovascular risk.
Triglycerides
A type of fat in the blood. High triglyceride levels, combined with high LDL or low HDL, increase cardiovascular risk.
Total Cholesterol
The sum of all cholesterol in your blood. Used alongside individual levels for risk assessment.
Desirable Cholesterol Levels
According to the European Society of Cardiology (ESC) and NICE:
| Measurement | Desirable Level |
|---|---|
| Total Cholesterol | Below 5 mmol/L (190 mg/dL) |
| LDL Cholesterol | Below 3 mmol/L (115 mg/dL) |
| HDL Cholesterol | Above 1.0 mmol/L men; Above 1.2 mmol/L women |
| Triglycerides | Below 1.7 mmol/L (150 mg/dL) |
For people at high cardiovascular risk, lower LDL targets may apply (below 1.8 mmol/L or even 1.4 mmol/L).
Risk Factors for High Cholesterol
Modifiable Risk Factors
- Diet high in saturated and trans fats: Red meat, full-fat dairy, fried foods, baked goods
- Physical inactivity
- Obesity: Particularly abdominal (central) obesity
- Smoking: Lowers HDL and damages blood vessels
- Excessive alcohol consumption
Non-Modifiable Risk Factors
- Age: Cholesterol levels tend to rise with age
- Gender: Before menopause, women generally have lower total cholesterol than men. After menopause, LDL tends to rise
- Family history: Familial hypercholesterolaemia is a genetic condition causing very high cholesterol levels from birth
- Ethnicity: Some populations have higher cardiovascular risk
Lifestyle Changes to Improve Cholesterol
NICE guideline NG238 (Cardiovascular disease: risk assessment and reduction) recommends:
Diet
- Reduce saturated fat intake to less than 10% of total energy
- Replace saturated fats with unsaturated fats (olive oil, nuts, avocado, oily fish)
- Eat at least 5 portions of fruits and vegetables daily
- Increase fibre intake (oats, beans, lentils, wholemeal bread)
- Eat oily fish at least twice a week (salmon, sardines, mackerel)
- Limit processed foods, pastries, and fried foods
- Plant stanols and sterols (found in fortified foods) can help lower LDL by 7–10%
Exercise
- At least 150 minutes of moderate-intensity aerobic activity per week
- Exercise raises HDL cholesterol and improves lipid profile
Weight Management
- Losing even 5–10% of your body weight can improve cholesterol levels
Stop Smoking
- Quitting smoking improves HDL cholesterol within weeks
Medication: Statins
When lifestyle changes are insufficient, or when cardiovascular risk is high, your doctor may prescribe statins. Common statins include atorvastatin and rosuvastatin.
NICE recommends offering statin therapy to people with a 10-year cardiovascular risk of 10% or more (assessed using the QRISK tool), as well as people with type 2 diabetes, chronic kidney disease, or familial hypercholesterolaemia.
How Statins Work
Statins reduce the liver's production of cholesterol, lowering LDL levels by 30–50%. They also have anti-inflammatory effects on blood vessels.
Side Effects
Most people tolerate statins well. Reported side effects include:
- Muscle aches (reported by 5–10% of patients; severe muscle damage is very rare)
- Digestive symptoms
- Headache
If you experience side effects, speak to your doctor - the dose or type of statin can often be adjusted.
Monitoring
If you are taking cholesterol-lowering medication:
- Blood tests every 3–6 months initially, then annually
- Liver function tests as recommended
- Assess symptoms and side effects at each visit
This article is for informational purposes only and does not replace professional medical advice. Always consult your doctor for personalised guidance.