High cholesterol is one of the most significant — and most treatable — causes of heart attack and stroke. Similar to high blood pressure, it often presents no symptoms, with the first indicator frequently being a cardiac event that could have been avoided through proper cholesterol assessment. Fortunately, modern high cholesterol treatment has improved immensely, allowing for personalised management tailored to your individual risk. Additionally, there are now a wide range of options available beyond just statins, making cholesterol consultation more comprehensive than ever.
Cholesterol is a fatty substance carried in the blood that your body needs, but maintaining the right balance is crucial. A cholesterol assessment can help you understand your levels better:
- LDL cholesterol, often referred to as 'bad' cholesterol, deposits cholesterol in artery walls, leading to plaque build-up (atherosclerosis). The higher your LDL and the longer it remains elevated, the greater your lifetime risk of heart attack and stroke.
- HDL cholesterol, known as 'good' cholesterol, assists in removing cholesterol from circulation.
- Triglycerides are another type of fat in the blood associated with cardiovascular risk, often elevated in cases of weight gain, diabetes, and alcohol consumption.
- Lipoprotein(a), or Lp(a), is an inherited particle that raises risk independently. Though it is not included in standard cholesterol tests, around 1 in 5 individuals have elevated levels, making it important for everyone to undergo a cholesterol consultation at least once to measure it.
Importantly, there is no universal 'normal' cholesterol number applicable to everyone. The acceptable level for a healthy 35-year-old differs from targets for individuals with diabetes, a strong family history of heart disease, or existing artery conditions. Therefore, cholesterol should always be interpreted within the context of your overall risk, especially when considering high cholesterol treatment options.
Raised LDL cholesterol is a direct cause of coronary artery disease — the evidence for this is among the most robust in medicine. Over the years, cholesterol deposits narrow the heart's arteries and can lead to heart attacks when plaques rupture. This highlights the importance of a thorough cholesterol assessment and consultation. The powerful corollary is that lowering LDL cholesterol reliably lowers risk; the earlier and longer it is lowered, the greater the benefit. Effective high cholesterol treatment can reduce LDL to levels where plaque progression halts — and in some cases, even partially reverses.
Your first appointment lasts around 30 minutes and includes:
A full review of your cholesterol history — previous results, treatments tried, and any side effects experienced, forming the basis of your cholesterol consultation.
A comprehensive cardiovascular risk assessment — blood pressure, diabetes, smoking, weight, family history, and lifestyle, combined into your personal risk estimate.
A physical examination and resting ECG performed in clinic.
A personalised plan — including advanced lipid testing where needed and artery imaging where it would alter management, alongside a clear treatment recommendation for high cholesterol treatment with specific targets.
Cholesterol management is most effective when guided by complete information, which is essential during a cholesterol consultation. I can arrange rapid access to:
Advanced lipid profile — LDL, HDL, triglycerides, non-HDL cholesterol, and Lp(a), which standard NHS panels usually omit.
Coronary artery calcium score — a quick CT scan quantifying calcified plaque in your heart arteries. For many people with borderline risk, this single test settles the statin question: a score of zero is reassuring; a raised score confirms that high cholesterol treatment will genuinely benefit you.
CT coronary angiogram — detailed non-invasive imaging of the artery walls where symptoms or risk warrant it.
Other dedicated non-invasive imaging tests — these will be tailored to your risk profile.
Blood tests — diabetes screening, thyroid, kidney, and liver function.
Genetic testing — where familial hypercholesterolaemia is suspected.
This 'treat the arteries, not just the number' approach means that cholesterol assessment and treatment decisions rest on evidence about your arteries, not just population averages.
Lifestyle measures form the foundation of effective cholesterol management: a Mediterranean-style diet, regular physical activity, weight management, and quitting smoking all contribute to improving your lipid profile and overall cardiovascular risk. For some individuals with modestly raised cholesterol and a low overall risk assessment, lifestyle modifications alone may suffice for high cholesterol treatment.
Statins remain the first-line medication for cholesterol management — they are among the most studied drugs in history, proven to be effective and safe for the vast majority of patients. While concerns about statin side effects are common, genuine intolerance is much rarer than often believed and is frequently resolved through a different statin, adjusted dosing, or a revised dosing pattern.
Beyond statins, there are now several options available for cholesterol treatment:
- Ezetimibe — a well-tolerated tablet that provides meaningful LDL reduction
- Bempedoic acid — an alternative for those who are statin-intolerant
- PCSK9 inhibitors (injectable therapies) — powerful LDL-lowering injections administered every two to four weeks for high-risk patients or where tablets fall short
- Inclisiran — a twice-yearly injection that offers sustained LDL reduction
If you have faced challenges with statins or if your cholesterol levels remain high despite previous treatments, a cholesterol consultation can help identify almost always effective paths forward.
As a Consultant Interventional Cardiologist, I address the effects of high cholesterol every week in the catheter lab, bringing that insight to my cholesterol consultation for effective prevention. Beyond basic testing, I offer comprehensive cholesterol assessment, including Lp(a) measurement, advanced lipid profiling, and artery imaging, allowing us to make decisions based on your actual arteries rather than mere numbers. I provide a full range of modern therapies, including PCSK9 inhibitors and inclisiran, for patients requiring more than just statins for their high cholesterol treatment. With a PhD from King's College London and over 100 peer-reviewed publications, I ensure rapid access with same-week appointments at Heart Health Welbeck London (Marylebone), Cromwell Hospital (Kensington), The Wellington Hospital (St John's Wood), Bupa Health Care Canary Wharf, and The Essex Cardiothoracic Centre (Basildon). Consultations are available in English and Turkish, and I am recognized by all major private medical insurers, welcoming self-paying patients as well.
High cholesterol is often silent, but its consequences can be prevented with a timely cholesterol assessment and appropriate high cholesterol treatment. It's crucial to start early. To arrange a cholesterol consultation, please contact my practice team at one of my London or Essex locations.
Get in touch with Ms. Melinda Ziff (PA) at 020 3198 9826 or drozandemir.sec@outlook.com to schedule your consultation.