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Why you need to test your cholesterol

Pourquoi vous devez vérifier votre cholestérol

On entend beaucoup parler des dangers du cholestérol élevé, mais à moins de faire un test sanguin, vous n'avez aucune idée que vous en avez - sauf si vous avez une crise cardiaque ou un AVC, auquel cas il est trop tard. Même si vous faites un test sanguin, les résultats peuvent être déroutants - alors comment savoir ce que signifient vos tests sanguins et ce que vous devez faire à leur sujet ?

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Although we all think of cholestérol as a 'bad thing', our bodies couldn’t function without it. We need cholesterol - it helps form part of the walls of all the cells in our bodies, and we couldn’t survive if we didn't have any. But most of us have far too much in our bloodstream. That means the excess builds up on the inside of our arteries as plaques, furring up the walls and reducing blood flow.

Sometimes one of these plaques ruptures, and blood clots around it inside the artery, blocking it completely. If that artery supplies blood to your heart, the result is a crise cardiaque - if it's in your brain, a AVC is the outcome. And while raised cholesterol isn't the only risk factor, it plays a major role.

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Know your levels

So knowing your cholesterol is crucial if you want to cut your risk of one of these devastating conditions. Until recently, everyone aged 40-75 has been entitled to a free health check on the NHS every five years, but that's changing - apparently the new-style checks will target certain populations. But your GP or practice nurse will be happy to advise if you need a test, and to carry it out if you do. You can also book a cholesterol test with your pharmacist through Patient Access - they can tell you whether you need to see your GP for treatment.

Your cholesterol result comes in different parts - the ideal results will depend on a variety of other factors in your medical history. However, as a general rule of thumb, your total cholesterol (which should be under 5 for most people); your 'bad' LDL cholesterol (ideally under 3) and 'good' HDL (which should be over 1 - the higher the better). If you have diabète or have had a heart attack or stroke, your doctor will want to aim for lower levels.

If you haven't had a heart attack or stroke, these results will help determine your risk of heart attack or stroke over the next 10 years. If it's over 10%, your GP will offer daily statin tablets. Most of the l'anxiété over statin side effects has proved not to be true, and most people have few or no side effects. They won't make you feel better in the short term, but they can cut your risk of heart attack dramatically.

Et perdre du poids if you're en surpoids can significantly lower your cholesterol as well as your pression artérielle et diabète de type 2 risk. Sugar doesn’t specifically raise your cholesterol, but it does make you prone to weight gain, which raises it.

FH (familial hypercholesterolaemia) affects about 1 in 250 people in the UK. It's different to 'traditional' raised cholesterol, which affects about half the adult population, because it runs in families. You inherit a defective gene which stops you from being able to process cholesterol properly. That in turn means fatty plaques build up on the inside of your arteries at a much earlier age than usual. People with FH are therefore at much higher risk of heart attack, and often have heart attacks in their 40s and 50s, even if they lead really healthy lives. If you inherit a copy of the faulty gene from both parents, heart attacks happen even earlier without treatment.

NICE (the National Institute for Health and Care Excellence) published new guidance a year or two ago. As a result, people with suspected or definite FH should be referred to a specialist clinic so they can have a formal diagnosis (with gene testing) and so that family members can be checked. If you've inherited the gene, you'll need counselling as early as possible and should start statin treatment in your late teens or 20s as a rule.

The good news is that treatment with medicine can dramatically reduce your risk and even bring your risk down to normal - but you need to be diagnosed and treated. That's where the problem lies - it's thought about 90% of people in the UK aren't diagnosed. So if close relatives (parents, siblings, children) have had a heart attack under 60, tell your GP. If they have high cholesterol, find out how high - if their total cholesterol was over 7.5 mmol/L or their 'bad' LDL over 4.9, tell your GP.

Avec remerciements au magazine My Weekly, où cet article a été initialement publié.

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About the authorView full bio

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Dr Sarah Jarvis

SEO Executive

MA (Cantab), BM, BCh (Oxon), DRCOG, FRCGP, MBE

After training in medicine at Cambridge and Oxford, Dr Sarah Jarvis MBE became a GP.

About the reviewerView full bio

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Dr Colin Tidy, MRCGP

Médecin généraliste, Auteur médical

MBBS, MRCGP, MRCP (Paediatrics), DCH

Dr Colin Tidy is an NHS Doctor, based in Oxfordshire.

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