More fibre is a good move (Image: Xavier Lorenzo via Getty Images)
A cardiologist has explained why feeling healthy doesn’t necessarily mean your heart is protected – and the simple steps that can help reduce cardiovascular risk. You could feel perfectly healthy and still have high cholesterol, putting your long-term heart health at risk without any obvious warning signs.
High cholesterol often causes no symptoms, meaning the only way to know your levels is through a blood test. Yet understanding the results – and what they mean alongside other risk factors – can be an important step towards preventing future heart problems.
October marks National Cholesterol Month, with HEART UK running its 2026 campaign under the message ‘Cholesterol Matters. Every Swap Counts’, encouraging people to understand their cholesterol and make practical changes to protect their heart health.
Dr Francesco Lo Monaco is a preventative cardiologist and founder of The National Heart Clinic on London’s Harley Street. He is also the author of Heart Saviour, a new book designed to show how small, consistent changes can make life-changing differences to health and longevity. He explained why knowing your numbers matters.
Know your cholesterol number
Dr Lo Monaco said: “One of the challenges with high cholesterol is that people can feel completely well and assume everything is fine. But cholesterol doesn’t usually cause symptoms you can feel, so you cannot judge your cardiovascular health simply by how healthy you feel. Knowing your cholesterol levels gives you useful information, but the important thing is understanding what those numbers mean for your individual risk.”
What do your cholesterol numbers actually mean?
A cholesterol test, often called a lipid profile, measures different fats in your blood. Results may include total cholesterol, HDL cholesterol, non-HDL cholesterol and triglycerides.
HDL is often described as ‘good’ cholesterol because it helps transport cholesterol back to the liver. Non-HDL cholesterol includes the cholesterol carried by particles that can contribute to fatty build-up in artery walls.
Dr Francesco Lo Monaco (Image: Dr Francesco Lo Monaco)
For healthy adults, a total cholesterol level below 5mmol/L and non-HDL cholesterol at or below 4mmol/L are commonly used as general UK guide levels. However, these figures are not a complete assessment of someone’s cardiovascular risk, and individual targets may differ.
Dr Lo Monaco said: “It’s important not to focus on just one number in isolation. Your clinician will consider your cholesterol results alongside factors such as your blood pressure, age, smoking status, diabetes, medical history and whether you have a family history of cardiovascular disease. That wider picture helps determine what action, if any, is needed.”
Why cholesterol is essential
Cholesterol is essential for the body, helping to build cells and produce hormones, including oestrogen, testosterone and cortisol.
“Cholesterol itself isn’t bad,” Dr Lo Monaco said. “The concern is when certain cholesterol-carrying particles become too high, increasing cardiovascular risk.”
Two important markers to ask about: ApoB and Lp(a)
Dr Lo Monaco highlighted two additional markers that may help clinicians assess cardiovascular risk in appropriate patients.
He said: “ApoB measures potentially harmful cholesterol-carrying particles, while Lp(a) is largely genetically determined and can increase heart disease risk even when standard cholesterol levels appear normal.”
Whether these tests are appropriate depends on an individual’s circumstances and should be discussed with a healthcare professional.
Five ways to support healthier cholesterol levels
The good news is that there are practical steps people can take to support their cardiovascular health.
1. Swap some saturated fats for unsaturated fats
Replacing foods high in saturated fat with sources of unsaturated fat, such as olive oil, nuts, seeds and oily fish, can help improve cholesterol levels.
2. Eat more fibre-rich foods
Beans, lentils, fruit and vegetables provide fibre, while oats and other foods containing soluble fibre can help lower LDL cholesterol.
Regular physical activity supports cardiovascular health and can help improve some blood-fat measurements. Walking, cycling, swimming and other activities you enjoy can all contribute.
Smoking damages blood vessels and increases cardiovascular risk. Stopping smoking is one of the most important steps people can take to protect their heart health.
5. Know when lifestyle changes aren’t enough
Healthy habits can make a meaningful difference, but genetics and other medical factors also influence cholesterol. Some people will need medication, such as statins, alongside lifestyle changes to reduce their risk.
Dr Lo Monaco said: “There is no single food, supplement or lifestyle change that can guarantee protection from heart disease. The most effective approach is to understand your own risk, make sustainable changes and seek medical advice when needed. If you have high cholesterol, don’t assume that improving your diet alone will always be sufficient – treatment decisions should be based on your overall cardiovascular risk.”
Why it’s worth checking now
People who haven’t had their cholesterol checked, or who are unsure what their results mean, can speak to their GP or healthcare professional about testing and their individual cardiovascular risk. For Dr Lo Monaco, this focus on prevention is central to both his work at The National Heart Clinic and the message behind Heart Saviour: that small, consistent changes can make a meaningful difference to long-term health.
“Prevention is about identifying risks before they develop into serious problems,” he said. “You don’t need to wait until you feel unwell to start taking your heart health seriously.”
