High cholesterol — assessment and treatment in Dubai
Also known as: Dyslipidaemia
High cholesterol — particularly raised LDL — is one of the strongest modifiable causes of heart attack and stroke. Diagnosis uses a lipid profile, ideally including ApoB, alongside an overall cardiovascular risk assessment. Treatment combines dietary change, activity and, where risk is significant, statins or other lipid-lowering medicines.
- · Interpreted in the context of overall cardiovascular risk, not in isolation
- · ApoB gives a more accurate picture than total cholesterol alone
- · Lp(a) should be checked at least once in adulthood
- · Statins are effective and safe in the vast majority of people
- · Lifestyle change remains foundational, whatever the medication
What high cholesterol is
Cholesterol is a fat-like substance carried in the blood on lipoproteins. High levels of LDL cholesterol (and its protein marker ApoB) drive the build-up of plaque in artery walls, leading to heart attacks and strokes.
How common it is
Cardiovascular disease is the leading cause of death worldwide and in the UAE. Raised cholesterol is very common and often develops silently over decades.
Main symptoms
- · Usually no symptoms until cardiovascular events occur
Less common symptoms
- · Yellowish deposits around the eyes (xanthelasma) in severe genetic forms
- · Chest pain on exertion (usually reflecting established heart disease)
Causes
- · Genetic factors, including familial hypercholesterolaemia
- · Diet high in saturated fat and ultra-processed food
- · Physical inactivity
- · Diabetes, thyroid disease and some medications
Risk factors
- · Family history of early cardiovascular disease
- · Diabetes and metabolic syndrome
- · South Asian or Middle Eastern ancestry
- · Smoking
- · Obesity
Possible complications
- · Heart attack
- · Stroke
- · Peripheral arterial disease
- · Aortic disease in advanced cases
How this condition is diagnosed
- · Fasting or non-fasting lipid profile: total cholesterol, LDL, HDL, triglycerides
- · ApoB when possible
- · Lp(a) at least once in adulthood
- · Cardiovascular risk score using a validated calculator (e.g. QRISK, SCORE2)
Questions your doctor may ask
- · Family history of early heart attack or stroke?
- · Diet, activity, smoking, alcohol?
- · Any existing medical conditions?
- · Current medications?
- · Muscle symptoms or previous statin problems?
Examination
- · Blood pressure and weight
- · Cardiovascular examination
- · Skin inspection for xanthelasma / tendon xanthomata
Blood tests
- · Full lipid profile
- · ApoB
- · Lp(a)
- · HbA1c
- · TSH
- · Liver function
When specialist referral may be needed
- · Suspected familial hypercholesterolaemia (very high LDL or strong family history)
- · Statin intolerance
- · Very raised triglycerides
- · Cardiovascular disease already established
Treatment
Overview
- · Mediterranean-style diet, higher in fibre, nuts, legumes, oily fish and olive oil
- · Regular physical activity
- · Smoking cessation and moderate alcohol intake
- · Statins where cardiovascular risk warrants
- · Ezetimibe, bempedoic acid or PCSK9 inhibitors in resistant cases (specialist)
Medicines
- · Statins are the first-line lipid-lowering medicine for most adults with elevated risk
- · Serious side effects are uncommon; most muscle symptoms have alternative explanations
- · Ezetimibe can be added when LDL targets are not reached
- · PCSK9 inhibitors are reserved for high-risk cases under specialist care
Do not stop or change any prescribed medicine without first discussing it with your clinician.
Lifestyle support
- · Reduce saturated fat and ultra-processed food
- · Add oily fish, nuts, legumes and soluble fibre
- · Weight change where indicated
- · Aerobic and resistance exercise
Monitoring and follow-up
- · Repeat lipid profile 8–12 weeks after starting or changing treatment
- · Then usually every 6–12 months
- · Liver function checked at baseline and after 3 months if on statin
Prevention and risk reduction
- · Early cardiovascular risk assessment in mid-life
- · Manage blood pressure, glucose and weight together
When to seek urgent help
- · Chest pain on exertion or at rest
- · Sudden weakness, facial droop or speech change
- · Sudden severe abdominal or back pain — call 998
Dubai emergency services: 998. Attend the nearest emergency department for red flags.
How Aafiyah can help
Your options
- · Full lipid profile with ApoB and Lp(a)
- · Cardiovascular risk assessment
- · Statin initiation, monitoring and titration
- · Coordinated referral to cardiology for complex or resistant cases
When a GP appointment is right
- · Never had cholesterol checked as an adult
- · Family history of early heart disease
- · Existing statin needs a review
When a home doctor visit may suit
- · Nurse-led home blood test with follow-up GP review is appropriate for many adults
Related pages
Related symptoms
Related tests
Related conditions
Frequently asked questions
Do I really need a statin?+
It depends on your overall cardiovascular risk, not on cholesterol in isolation. Above a defined 10-year risk threshold, statins clearly reduce heart attack and stroke. The decision is shared with your GP.
Are statins safe long-term?+
For the vast majority, yes. Serious side effects are uncommon, and the cardiovascular benefit is well-established.
Should I test Lp(a)?+
At least once in adulthood. It is largely genetic and identifies people who need tighter control of other risk factors.
References
- · NICE guideline CG181: Cardiovascular disease — risk assessment and reduction
- · ESC/EAS 2019 Guidelines for the management of dyslipidaemias
- · American Heart Association — Cholesterol Guidelines
Medically reviewed by Dr Shahbaz Afzal, MBBS MRCGP — British-trained Family Medicine Consultant, Aafiyah Care Clinic.
Reviewed 2026-07-01. Next review due 2027-01-01.
This page is general information for adults living in or visiting Dubai. It is not a diagnosis or a substitute for a personal medical consultation. Do not stop or change prescribed treatment without medical advice.
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