I have high cholesterol

In brief

In brief

  • Cholesterol is important for the body.
  • Your body produces it itself and absorbs it from food.
  • High cholesterol is not a disease. It does not cause any symptoms.
  • High cholesterol can make your blood vessels narrower.
  • High cholesterol therefore increases the risk of cardiovascular disease.
  • A healthy lifestyle can help lower high cholesterol.
  • Sometimes medication is necessary too.
  • Dutch healthcare practices in general may differ from what you are used to in your home country. Learn more.
What is it

What is cholesterol?

Cholesterol is a fatty substance. Your body uses cholesterol to make cells, hormones and bile.

Your body makes cholesterol in the liver. You also absorb cholesterol from the food you eat.

Your cholesterol is measured with a blood test. You may eat before the blood test.

What will I notice?

Symptoms of high cholesterol

High cholesterol is not a disease. It does not cause any symptoms.

If your cholesterol is too high for many years, it can build up in the wall of your blood vessels. This makes your blood vessels narrower. They can then become blocked.

This can cause problems with your heart and blood vessels. For example, angina (chest pain), kidney damage, a heart attack or a stroke.

Your cholesterol along with other factors and diseases determine your risk of cardiovascular disease. Examples of such risk factors are: 

  • smoking
  • high blood pressure
  • diabetes
  • kidney damage
  • rheumatoid arthritis
  • not exercising enough
  • unhealthy diet
  • being overweight
  • stress

For more information, see cardiovascular disease (in Dutch). Your GP can make an overview of your risk.


Causes of high cholesterol

  • The amount of cholesterol in your blood changes because of what you eat. An unhealthy diet causes cholesterol levels to increase. An unhealthy diet means: not enough fruit and vegetables, not enough wholegrain products, a lot of sugar and a lot of saturated fat.
  • Some people naturally have high cholesterol. The body then makes too much cholesterol. We don’t know the reason for this.
  • Your cholesterol can also be high because high cholesterol occurs in your family. You then have hereditary high cholesterol (in Dutch). This occurs in 1 out of 450 people. People with hereditary high cholesterol have a higher risk of developing cardiovascular disease at a young age.
Normal values

How much cholesterol is normally in the blood?

Usually 4 things are measured in your blood: total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides.
The normal values in the blood (in healthy people who do not take medication and do not yet have cardiovascular disease) are shown below.

Total cholesterol

  • A total cholesterol level below 5 mmol/L is good.
  • We call a level higher than 8 mmol/L very high.

LDL cholesterol (bad cholesterol)

  • An LDL cholesterol level below 3 mmol/L is good.
  • At a higher LDL cholesterol level, your blood vessels can become blocked.

HDL cholesterol (good cholesterol)

  • An HDL cholesterol level above 1 mmol/L is good.
  • It’s okay if the HDL cholesterol in your blood is high. It is good for your blood vessels.


  • A triglyceride level below 2 mmol/L is good.
  • A higher value increases the risk of cardiovascular disease.

If you want to know what your cholesterol level should be if you use medication, for example because you already have cardiovascular disease, see cholesterol and medication (in Dutch).


Advice for high cholesterol

High cholesterol increases your risk of cardiovascular disease. It is therefore a good idea to lower your cholesterol. And also to deal with other factors that increase your risk. The most important measures are:

If you also have diabetes, rheumatoid arthritis or high blood pressure, it is important to treat these conditions properly as well.

Read more information and advice about cardiovascular disease (in Dutch).


When is medication necessary for high cholesterol?

Medication is not always necessary for high cholesterol. That depends on the overview of your risk (in Dutch). If, for example, you only have high cholesterol and you are otherwise healthy, medication is usually not necessary.

Medication usually is necessary:

  • if you already have cardiovascular disease (for example if you have had a heart attack or a stroke) and your LDL cholesterol is too high
  • if you have diabetes mellitus and your LDL cholesterol is too high
  • if your total cholesterol is very high (8 or higher)
  • if you have several factors that increase your risk of cardiovascular disease (such as smoking and high blood pressure)
  • if you have hereditary high cholesterol.

Your GP can tell you if medication is necessary in your situation.

If you take medication (in Dutch), it remains important to maintain a healthy lifestyle.

What happens next

What happens next if you have high cholesterol?

  • A healthy lifestyle (in Dutch) remains very important.
    Watch the video: Maintaining a healthy lifestyle (in Dutch).
  • You have regular check-ups with your GP or the practice nurse (praktijkondersteuner).
    Together you discuss your lifestyle: what is going well and what could be better. Your GP checks your blood pressure and weight.
  • The cholesterol in your blood is measured at least every 5 years. Sometimes your cholesterol needs to be checked earlier. For example, if you have a higher risk, but not so high that you need medication immediately.
  • When you start taking medication for high cholesterol, your cholesterol is checked after 3 months.
    It is then checked every 3 months until it is low enough. Afterwards, it is no longer necessary to check it that often.
More information

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