PATIENT INFORMATION
Very high cholesterol
Your cholesterol is high enough that we want to find out why, rather than treat it as ordinary.
What this result means
At this level there are 2 things to sort out.
The first is whether something else is pushing your cholesterol up. The second is whether you have an inherited condition called familial hypercholesterolaemia, usually shortened to FH.
About FH
FH is not rare. Around 1 in 250 people have it.
A single gene passed down through families causes it. It means the body cannot clear cholesterol properly, from birth.
People with FH have a high cholesterol whatever they eat. That is why diet alone never fixes it, and why it is not something you have caused.
FH responds very well to treatment, and treatment works best when it starts early. Finding it is good news.
What we have done
We have arranged blood tests for the things that raise cholesterol on their own. These are your thyroid, your blood sugar, your kidneys and your liver.
We have also looked at your record for the pointers to FH. These include your cholesterol level and a close relative who had a heart attack or stroke young.
What happens next
Your text message names one of these.
What it means for your family
FH runs in families. If you have it, each close relative has a 1 in 2 chance of having it too.
That means your children, your brothers and sisters, and your parents.
Most of them will not know.
Finding them and treating them early is the most valuable thing to come out of this diagnosis.
You do not need to do anything about that yet. If FH is confirmed, the clinic organises family testing and will talk you through how to raise it.
What you need to do
Do
- book any blood tests we have asked for
- take the tablet every day and collect your repeat, if we have started one
- think back over your family history and bring it to your appointment
- get help to stop smoking if you smoke, because it matters more with a high cholesterol
We want to know about any parent, brother, sister or child who had a heart attack, angina or stroke. Their age at the time matters most.
Immediate action required: Call 999 now if you have:
- chest pain at rest, or chest pain lasting more than 15 minutes
- sudden weakness or numbness in the face or one arm
- sudden trouble speaking or understanding speech
Non-urgent advice: Contact the surgery if:
- you have not heard from the clinic within 8 weeks
- you get chest pain or tightness when you walk uphill or hurry
- you get new muscle pain or weakness on a tablet
More information
HEART UKWhat is familial hypercholesterolaemia?www.heartuk.org.uk/cholesterol/what-is-fh NHS.UKHigh cholesterol: causes, tests and treatmentwww.nhs.uk/conditions/high-cholesterol/
Reviewed 26 August 2026 ยท next review 26 February 2027