Medically reviewed by Dr Pinakin V Parekh, General & Interventional Cardiologist (MBBS (Singapore), MRCP (UK), GDFM (Singapore), FAMS (Singapore), FRCP (Glasgow)). Last Updated: 2026, 28 August
Founder & Medical Director of Trident Heart Centre
Dr Pinakin V Parekh is an interventional cardiologist in Singapore with over 20 years of experience in heart care. He specialises in the diagnosis and treatment of heaart diseases, including procedures such as angiogram and angioplasty.
Cholesterol is a fatty substance found in your blood. Your body needs some cholesterol to build healthy cells, but too much can become harmful.
There are two main types:
When LDL cholesterol is too high, it can lead to plaque buildup in the arteries, increasing the risk of heart disease.
LDL cholesterol levels are used to assess your risk of cardiovascular disease.
In general:
Optimal
Less than 2.6 mmol/L
Near optimal / borderline
2.6 – 3.3 mmol/L
High
3.4 mmol/L and above
Your doctor may interpret your results differently depending on your overall heart risk profile, including blood pressure, diabetes, and family history.
High cholesterol usually does not cause any symptoms, especially in the early stages.
Most people only discover it during a routine blood test or health screening. This is why it is often called a “silent condition.”
Even though you may feel well, high cholesterol can still be damaging blood vessels over time, increasing cardiovascular risk without warning signs.
High cholesterol can develop due to a combination of lifestyle, genetic, and medical factors. In many patients, more than one factor contributes to elevated cholesterol levels:
Certain medical conditions, such as diabetes, thyroid disorders, and kidney disease, can also increase the risk of developing high cholesterol or make it more difficult to control.
When LDL cholesterol is high, it can slowly build up inside the arteries and form plaque.
Over time, this can lead to:
Because this process develops silently over years, early detection is important.
High cholesterol is diagnosed through a simple blood test known as a lipid profile.
This test measures:
Your doctor may recommend fasting or non-fasting tests depending on your situation. Regular screening is especially important if you have other risk factors such as diabetes or high blood pressure.
Your LDL cholesterol number is an important piece of the puzzle, but it isn’t the whole picture. Two people with the exact same LDL level can have very different actual heart risk, depending on other factors at play.
This is why, for some patients, Dr Pinakin recommends looking at a few additional markers alongside standard cholesterol testing.
Lipoprotein(a), or Lp(a), is a cholesterol-related particle that’s mostly determined by genetics. Unlike LDL, it isn’t affected much by diet or exercise — so it needs to be specifically tested for rather than assumed. It’s particularly useful to check if you have a family history of heart disease, even if your other cholesterol numbers look fine.
Looking at both together can offer a fuller picture of risk than LDL on its own.
CRP is a marker of inflammation in the body. Since inflammation plays a role in how plaque forms and progresses, elevated CRP can point to increased heart risk, even in patients whose cholesterol numbers appear normal.
Homocysteine is a substance in the blood that, at high levels, has been linked to damage in blood vessel walls. It’s not needed for every patient, but can be useful for those with an unclear risk profile or a strong family history of heart disease.
High cholesterol can often be improved through a combination of lifestyle changes and, in some cases, medication.
Lifestyle plays a key role in cholesterol control:
Small, consistent changes can significantly improve cholesterol levels over time.
Some patients may need cholesterol-lowering medication if lifestyle changes alone are not enough to achieve healthy cholesterol levels.
Treatment options may include:
Injectable therapies may be considered for patients who cannot tolerate statins, have very high cholesterol levels, or require more intensive cholesterol lowering. Your doctor will recommend the most appropriate treatment based on your cholesterol levels and overall cardiovascular risk.
Certain foods can raise LDL cholesterol levels when eaten regularly.
These include:
Focusing on fresh, minimally processed foods can help improve cholesterol control.
High cholesterol cannot always be “cured,” but it can often be very well controlled.
With the right management, many patients are able to:
Even in genetic cases, treatment can still make a meaningful difference.
You should consider a medical review if you have:
Early assessment helps guide whether lifestyle changes alone are enough or if medication is needed.
Patients often value Dr Pinakin’s approach because it focuses on:
Assessing what your cholesterol levels mean in the context of your overall cardiovascular risk, rather than treating a blood test result alone.
Considering factors such as family history, blood pressure, diabetes, lifestyle habits, and specialised risk markers such as Lipoprotein(a), where appropriate, to build a more complete picture of your cardiovascular risk.
Tailoring recommendations based on individual risk, from lifestyle changes and monitoring to cholesterol-lowering medication when appropriate.
Yes, in many cases lifestyle changes can significantly improve cholesterol levels, especially in early stages.
Generally, an LDL level below 2.6 mmol/L is considered optimal, but targets may vary depending on your risk profile.
Improvements can often be seen within a few weeks to months with consistent lifestyle changes or medication.
For most people, eggs can be enjoyed in moderation as part of a balanced diet. Current evidence suggests that overall dietary patterns are usually more important than avoiding eggs completely
This depends on your age, risk factors, and previous cholesterol levels. Many adults benefit from regular cholesterol screening as part of routine health checks.
Dr Pinakin uses current, evidence-based methods to carefully evaluate and treat heart conditions, helping you feel confident in your care.
Every patient is treated as an individual, with attention to your full health and lifestyle, not just the heart problem.
From assessment to treatment, screenings and procedures are conveniently coordinated in one place for a smoother, more reassuring experience.
