I still remember sitting in my GP’s office, staring at a sheet of paper filled with numbers I didn’t fully understand. My blood test results had just come back, and according to the doctor, my cholesterol was “too high.”
He didn’t spend long explaining what that meant. Instead, he reached for his prescription pad and wrote down one word: statins.
I nodded. After all, why would my doctor give me pills if I didn’t need them? He’s the professional. So I went home and started taking them without much thought.
But something didn’t feel right. Not physically — at least not yet — but deep down. It bothered me that I didn’t really know why I was taking them, or whether my so-called “high cholesterol” was actually dangerous. I decided to do my own digging.
That’s when I discovered the story behind cholesterol is far more complicated — and far less scary — than the one we’ve been sold for decades.
How Cholesterol Became Public Enemy No. 1
Back in the 70s and 80s, heart disease rates were rising fast, and health authorities needed a clear villain. The simplest story they could tell was:
“Cholesterol clogs your arteries. Keep it low or you’ll have a heart attack.”
It was neat. It was scary. And it was easy to measure on a blood test.
But the truth is, cholesterol isn’t a criminal — it’s more like your body’s handyman. It repairs damaged cells, makes hormones, helps your body produce vitamin D, and keeps your brain functioning properly. Calling it “bad” is like blaming the builders for the cracks in the pavement.
The “total cholesterol” number my doctor was so worried about is actually a blunt instrument. It doesn’t show the difference between HDL — the “good” cholesterol — and LDL, which itself comes in harmless fluffy particles and smaller, denser ones that are more likely to cause trouble.
The real troublemaker? Inflammation. Cholesterol becomes a problem when your arteries are already damaged, often from stress, smoking, poor diet, or high blood sugar.
And here’s something surprising: for older adults, higher cholesterol can sometimes be protective. It’s linked to better immune function and faster repair — which might explain why some studies show they live longer with it.
The Statin Story
Of course, once statins were developed, the “cholesterol is bad” narrative gained even more momentum. These drugs became a blockbuster business, and lowering cholesterol turned into a universal prescription — even for people who might not need it.
The more I read, the more I realised my cholesterol might not be the fire that needed putting out. In fact, cholesterol might be the fire truck — showing up to the scene because something else is wrong. Inflammation is the spark, and sugar or processed food is the pile of oily rags in the corner.
Why My Numbers Might Be Different
As a Black man, there’s another layer to this story. Research shows that people of African or Afro-Caribbean descent often have cholesterol readings that look high on paper but don’t carry the same risk as in other populations.
Here’s why:
- Genetics — Many of us naturally make more LDL or have higher total cholesterol. But the LDL particles are often larger and fluffier — less harmful than the small, dense kind. Standard blood tests don’t make that distinction.
- Body composition — Black adults often have more lean muscle and denser bones, which can change metabolic readings like cholesterol without signalling higher heart risk.
- Higher HDL — Many of us naturally have more “good” cholesterol, which offsets LDL’s effects. But when you look only at the total number, it makes the result look artificially worrying.
- The reference ranges are outdated — Most cholesterol charts were set decades ago using mainly white European study groups. What’s “high” for them might be normal for us.
- Metabolic differences — Even with a good diet and exercise, our livers may process fats differently. That’s why some healthy Black athletes have “scary” numbers on paper but perfectly clean arteries.
The Real Bottom Line
For many Black people — and many others in midlife — slightly higher cholesterol doesn’t automatically mean danger. What really matters is the whole picture: inflammation, blood pressure, triglycerides, and blood sugar.
If those are in good shape, and your HDL is high with LDL that’s large and fluffy, you might not need to panic — or rush to fill that statin prescription — without further tests.
I’m not saying no one should take statins. For some people, they save lives. But I am saying you deserve the full story before swallowing the pill.
Because once you learn cholesterol’s true role, you stop seeing it as the villain — and start asking better questions about what’s really going on inside your body.
