What is cholesterol and how can you reduce it

Deven Seetanah, 24/7 health support line, team manager

Men’s health - coronary heart disease

16 March 2023

Coronary heart disease is the most common type of heart or circulatory condition.1 In 2019, it was the leading cause of death for both men and women throughout the world.2 In the UK, it’s responsible for around 66,000 deaths per year, killing around one in eight men.1

These unenviable statistics make it the leading cause of premature death in the UK,1 but it’s also very preventable. Deven Seetanah, team manager of AXA Health's 24/7 health support line for members, outlines the common causes, possible symptoms, and some preventative measures for coronary heart disease.

What is coronary heart disease?

Coronary heart disease (CHD) is caused when fatty deposits build up in the arteries that deliver blood to the heart. This is a gradual process but, over time, these fatty deposits – called plaques or atheroma – cause the coronary arteries to harden and narrow.

This obstructs the blood supply to the heart, restricting the amount of oxygen that gets delivered to vital organs. It also increases the risk of blood clots. If left untreated, CHD can cause life-threatening issues like heart attacks and strokes.

What are the symptoms of coronary heart disease?

There are usually no early signs of coronary heart disease, and some people might not experience any symptoms before being diagnosed or experiencing complications. But, over time, certain symptoms may develop. These include:

  • angina (chest pain or discomfort)
  • shortness of breath
  • feeling faint or nauseas
  • pain throughout the body

It’s important to note that not everyone will experience the same symptoms and, of course, most of these issues can also be caused by any number of other conditions. But if you experience these kinds of symptoms, it’s worth visiting your GP. Particularly if your lifestyle or circumstances place you at a higher risk.

What increases my risk of developing coronary heart disease?

Most of the main risk factors associated with coronary heart disease (CHD) are lifestyle-based. This also means that the condition can be prevented if you make try and make healthier choices and develop good habits.

The following conditions and habits will put you at a higher risk of developing coronary heart disease:


It’s no secret that smoking is bad for you. There are so many reasons to quit. Smoking damages the lining of the arteries, reduces the blood’s oxygen levels and puts strain on the heart, which means coronary heart disease is one of its biggest risk factors.

Obesity or being overweight

Being overweight drastically increases the risk of coronary heart disease.

Firstly, the habits that cause weight gain (i.e. poor diet and alcohol) can increase the amount of fatty material that builds up in your arteries. Meanwhile the consequences of being overweight (i.e. high blood pressure) can damage the heart and arteries.

For more information, check out our article on maintaining a healthy weight.

Lack of exercise

As well as being one of the causes of obesity, inactivity can weaken the heart muscle.

Like any muscle in the body, the heart needs to be exercised so it can stay strong and work to its full capacity. Staying active can therefore help maintain healthy blood pressure, get more oxygen flowing through your body and help reduce the build-up of plaque in the arteries.

Drinking too much alcohol

Drinking too much alcohol damages the arteries in a similar way to smoking. It can also contribute to obesity, high blood pressure and high cholesterol, all of which are major risk factors for CHD.

High blood pressure

Also known as hypertension, high blood pressure can be serious. It can be caused by most of the above habits or lifestyle choices. When your blood pressure is consistently too high, your arteries can stiffen, much like an over-worked muscle, which makes it easier for fatty deposits to build up and obstruct the blood flow.

High cholesterol

Cholesterol is a fatty substance that can cause blockages in blood vessels and arteries. We need some of it to stay healthy, but too much is dangerous. High cholesterol is caused by eating too much saturated fat, as well as the usual suspects: smoking, drinking alcohol and being overweight.

Find out more about cholesterol and how we can reduce high levels


Both type 1 and type 2 diabetes can cause a build-up of blood sugar, which can cause damage to the coronary arteries. This damage makes it easier for plaque and fatty materials to build up. The issues, habits and conditions listed above are all leading causes of type 2 diabetes.

Having a family history of CHD can also be a possible factor. According to the NHS, your risk is increased if you’ve had a male relative under 55 or a female relative under 65 that had the condition.3

Find out more about diabetes in our article Dealing with diabetes – your questions answered.

How is coronary heart disease diagnosed?

To check for coronary heart disease, your GP can carry out an assessment and conduct certain tests if they feel you’re at risk. This could involve:

  • discussing your family history
  • discussing your lifestyle
  • checking your blood pressure
  • doing blood tests to check cholesterol levels

These initial risk assessments will likely be carried out before any further examination, but you may then be referred for more tests to help make a diagnosis.

These tests would look for various heart or circulatory issues, and might involve:

  • an exercise stress test
  • an echocardiogram or electrocardiogram (ECG), which examine the heart and surrounding blood vessels
  • X-rays
  • MRI or CT scans

How can I prevent coronary heart disease?

When it comes to coronary heart disease, prevention is the best cure. Based on the risk factors, you might be able to guess what some of the recommended measures are to help prevent CHD. They’re relatively universal recommended habits and lifestyle choices that we should all try and adopt for a healthier lifestyle. But if you’re at risk of CHD, they’re vital:

Healthy eating

Try and avoid saturated fats and limit salt intake to 6g per day. Aim to eat more vegetables, fruits, fibres and whole grains. Check out our diet and nutrition pages for detailed insight and guidance.

Exercise more

Aim for around two and a half hours of moderate exercise per week. This is where your heart is made to work, and your breathing becomes heavier. Make sure you exercise safely and look after your muscles, bones and joints. Our exercise and fitness pages are packed with ideas and guidance.

Manage your weight

Healthy eating and exercise are key for managing your weight, but it’s important to know what a healthy weight is for you and monitor your progress. We know you’ll have questions, so for tangible answers and expert insight, check out our weight loss FAQs.

Avoid smoking

We all know smoking is bad for your health, but exactly how does quitting make life better? Here are 10 ways your health will improve when you stop smoking.

Reduce your alcohol intake

Try and limit yourself to 14 units of alcohol per week, and make sure it’s not all in one sitting. The health benefits extend beyond cardiovascular health, and they become more important as we get older.

For more information and helpful ideas, check out our useful guide, How much is too much alcohol?

Lower your blood pressure

We’ve mentioned exercise for weight loss and overall health, but it can also help reduce high blood pressure. Check out our senior physiologist’s article, which outlines six ways to lower your blood pressure with exercise, as well as the best types of exercise to try

How is coronary heart disease treated?

If you’ve been diagnosed with CHD, your doctor may still recommend lifestyle changes in the first instance. This will, of course, depend on your individual situation, but looking after your overall health can still help reduce the risk of experiencing a serious incident because of the condition.

Further to lifestyle changes (as listed above), treatment can include:


From blood thinners and aspirin to statins for cholesterol, there are plenty of medications that can be used to treat heart disease, usually by reducing blood pressure or widening the arteries.


This is a procedure where a small balloon is inserted into the artery to push the narrowed area outwards and allow blood to flow more easily. It can be a planned procedure, or it can be performed in an emergency.


Bypass surgery, also known as a heart bypass, involves a blood vessel being grafted onto the affected artery to ‘bypass’ a blockage. There are different approaches to this type of surgery depending on the location and severity of the obstruction.

With coronary heart disease, you’ve probably noticed that a lot of the risks tie into one another. For example, a lot of the risk factors associated with CHD – inactivity, excessive drinking, poor diet – can also lead to obesity. Meanwhile, obesity is itself a leading cause of CHD. So, by reducing your risk of obesity, you’ll reduce the risk of developing heart disease, and vice versa.

It’s therefore worth adopting a holistic approach to preventing and treating coronary heart disease. Know that, by making healthy choices, you’ll experience multiple benefits that will all help you manage your wellbeing and find your feelgood.


  1. British Heart Foundation – UK Factsheet
  2. British Heart Foundation – Facts and figures
  3. NHS – Coronary heart disease - causes