High LDL cholesterol: what your result means and what to do next
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 21 October 2026
High LDL cholesterol explained: mg/dL and mmol/L, why your target depends on heart risk, when to suspect a family cause, and how follow-up works in Spain.
You don't have to figure this out alone
Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
High LDL cholesterol means too much "bad" cholesterol in your blood. Over the years it can build up in your artery walls. Spanish labs report it in mg/dL, not mmol/L. There is no single normal value: your target depends on your own heart risk. Here is how to read the number, and what happens next.
- LDL cholesterol can build up in the walls of your arteries. Over years, this raises the risk of heart attack and stroke.
- Spanish labs use mg/dL. To get mmol/L, divide by about 38.7. So 116 mg/dL is about 3.0 mmol/L.
- Your target depends on your overall risk, not on the lab range alone. The higher the risk, the lower the target.
- An LDL of about 190 mg/dL or more, or heart disease at a young age in the family, can point to an inherited cause.
- If you already take a statin or another cholesterol medicine, do not stop it because of one result.
- A follow-up works best when you bring old and new reports, your medicine packaging and a short list of questions.
- High LDL gives no symptoms. Chest pain, sudden weakness or sudden breathlessness mean 112, not a video visit.
What is LDL cholesterol?
LDL is the part of cholesterol that doctors watch most closely, because it is the kind that sticks to artery walls. Cholesterol itself is a fat your body needs. It travels in the blood inside small particles. The two main ones are LDL and HDL.
- LDL (colesterol LDL) carries cholesterol to the body. Too much of it can build up in the artery walls. It is often called "bad" cholesterol.
- HDL (colesterol HDL) carries extra cholesterol back to the liver. It is often called "good" cholesterol.
A cholesterol test also shows total cholesterol and triglycerides, another kind of blood fat. Some labs add non-HDL cholesterol. That is total cholesterol minus HDL. You can read more about each value at MedlinePlus.
How do I convert LDL from mg/dL to mmol/L?
Divide the mg/dL value by about 38.7. Spanish reports give cholesterol in mg/dL. The UK and many other countries use mmol/L. Here are common values side by side:
| LDL (mg/dL) | LDL (mmol/L) |
|---|---|
| 55 | 1.4 |
| 70 | 1.8 |
| 100 | 2.6 |
| 116 | 3.0 |
| 190 | 4.9 |
If you compare an old result from home with a new Spanish one, convert one of them first. Never assume two reports use the same unit. Check the label printed next to the number.
What is a normal LDL cholesterol level?
There is no single normal value. The lab range is a rough guide. What matters most is your overall chance of heart disease or stroke in the coming years. Doctors work this out from:
- Age and sex.
- Smoking.
- Blood pressure.
- Diabetes and kidney disease.
- Family history of early heart disease.
- Past heart attack, stroke or narrowed arteries.
The heart guidelines used in Spain (ESC/EAS) set lower LDL targets for people at higher risk. As a rough idea:
| Overall risk | Common LDL target |
|---|---|
| Low | Under 116 mg/dL (3.0 mmol/L) |
| Moderate | Under 100 mg/dL (2.6 mmol/L) |
| High | Under 70 mg/dL (1.8 mmol/L) |
| Very high, for example after a heart attack | Under 55 mg/dL (1.4 mmol/L) |
So the same LDL can be fine for one person and too high for another. Your doctor places you in a group after looking at all your risks. In the UK, the NHS uses a risk score called QRISK in the same way.
When does a very high LDL need a closer look?
An LDL of about 190 mg/dL (4.9 mmol/L) or more, or heart disease in young relatives, needs a closer look. Some people have high LDL from birth. This is called familial hypercholesterolaemia. It runs in families and raises the risk of heart disease at a young age.
Tell your doctor if:
- Your LDL is about 190 mg/dL (4.9 mmol/L) or more.
- A parent, brother or sister had a heart attack or stroke at a young age.
- You have yellow lumps on tendons, or yellow patches around the eyes.
Other conditions can also raise LDL. These include an underactive thyroid, kidney or liver problems, and some medicines. A doctor may check for these before deciding on a plan. If your thyroid test (TSH) was also high, mention it.
What happens after a high LDL result?
A single LDL result is a starting point, not a treatment decision by itself. Common next steps are:
- Work out your overall heart risk.
- Check blood pressure, blood sugar and kidney function, if not done.
- Look at diet, activity, weight, alcohol and smoking.
- Repeat the test after a few months of changes, if that suits your risk.
- Talk about medicine if your risk is high, or if lifestyle changes are not enough.
Lifestyle helps everyone. Eating less saturated fat, more fibre, being active and not smoking all count. Some people still need medicine, most often a statin, to reach their target. That is a decision for your doctor, made with you. Mayo Clinic has a clear overview of the options.
If you already take a cholesterol medicine, do not stop it because of one result. Talk to your doctor first.
Do I need to fast for a cholesterol test?
Often not. Many labs no longer need you to fast. Some still ask for a fast of about 10 to 12 hours, mainly because of triglycerides. Follow the lab's own advice. A recent illness, pregnancy or a big change in diet can change the result for a while.
How does cholesterol follow-up work if you have moved to Spain?
Follow-up means a regular review of your results, your treatment and your heart risk, so your care stays consistent after the move. Moving countries can interrupt a care plan even when you feel well. Your old GP may hold the lab history. Your medicine may have a different name in Spain. Explaining a concern in another language adds friction. You can prepare for all of this.
A good follow-up has four parts: records, review, plan and next check. You collect the records. The doctor does the review, including whether a video visit is enough or you need to be seen in person.
Which records should I gather?
Start with what you can collect without paying for another visit. A recent result shows where things stand now. An earlier one gives context. If you cannot find every report, bring what you have and say what is missing. Do not guess a number from memory.
- Save the most recent lipid report and any earlier reports you can access.
- Keep each report's date, units and lab details visible.
- Add letters or treatment plans from your previous doctor.
- Mark any report you cannot read clearly instead of copying it from memory.
What should I write down about my treatment?
Make a plain list before the visit. Write the medicine name exactly as it appears on the packaging, the strength printed there, and how you take it. If you are not sure whether a medicine in Spain matches one from home, ask the doctor rather than assuming it does. See our guide to medicines in Spain.
- Record medicine names and any other treatments you take.
- Note side effects or missed doses.
- Write down what your previous doctor asked you to monitor.
- Put your main questions in order, most pressing first.
What happens when my prescription runs out?
Raise this early in the visit, but treat it as part of the review, not as paperwork with a guaranteed answer. The doctor needs to assess your situation first. Treatment and prescriptions are issued solely at the doctor's discretion, where clinically appropriate, following a genuine evaluation. If a prescription is issued, it is a private electronic prescription under Spanish law, dispensed in Spanish pharmacies. Dispensing still depends on the pharmacy and on stock. Do not change or stop treatment without talking to a doctor.
- Show the current prescription or the medicine box if you have it.
- Say when your supply is due to end.
See how electronic prescriptions work in this practice.
How should the visit end?
Before the call ends, make sure you understand the next action. It might be getting a report, arranging a test, carrying on with your plan, or seeing a doctor in person. The right interval depends on you. Do not copy someone else's schedule.
- Confirm what you need to do next and who will review any new results.
- Ask when your plan should be looked at again.
- Keep the advice with your lab and medicine records.
Which follow-up option fits your situation?
For a planned review with records already in hand, a video visit is a practical route to continuity. For symptoms that need an exam, choose in-person care. The most common mistakes are bringing only the latest number, comparing figures without checking units, treating the visit as an automatic refill, and leaving without a next step.
| Option | Best for | Key limitation |
|---|---|---|
| Your doctor back home | People who can still reach a doctor who knows their history | May not be able to manage care or prescribe for you in Spain |
| In-person GP visit in Spain (centro de salud or private clinic) | People who need a physical exam or a local test | You still need to bring old records and explain your treatment history |
| Video visit with a GP licensed in Spain, in English or Spanish | A planned review of results, medicines and next steps; €50 for 15 minutes | Not suitable for every concern; treatment and prescriptions are never guaranteed |
| Emergency department or 112 | A medical emergency | Not a substitute for planned long-term follow-up |
What happens in a video review of your cholesterol results?
Dr. Yelamo is a GP licensed in Spain. He goes through results you already have, by video. Visits run every day, 07:30–20:30 (Spain time); choose an available time in the live calendar. In the visit he will:
- Read the full report, with units and dates.
- Convert units and compare with past results from other countries.
- Go over your heart risk factors with you.
- Explain what your LDL means for you, and what is done next.
- Review your current medicine and how you are getting on with it.
- Tell you if you need a test or an exam in person.
No test or prescription is promised before the visit. Treatment and prescriptions are issued solely at the doctor's discretion, where clinically appropriate, following a genuine evaluation. The Urgent Care video visit lasts 15 minutes and costs €50, with an itemised invoice included. It is for urgent, non-emergency care and planned reviews like this one. If other values on your report puzzle you, see blood test results explained.
Have a cholesterol result you are not sure about, or a statin plan that needs a review in Spain?
Dr. Yelamo, a GP licensed in Spain, goes through your results and your treatment by video, in English or Spanish, and tells you what needs to happen next.
Emergencies
High LDL causes no symptoms by itself. But call 112 at once, or go to the nearest emergency department, if you have:
- Chest pain or pressure that lasts more than a few minutes, or spreads to the arm, neck or jaw.
- Sudden weakness or numbness of the face, arm or leg, or trouble speaking.
- Sudden severe shortness of breath.
- Fainting, or a racing or irregular heartbeat with dizziness.
Do not wait for a video visit. In several regions 061 is the medical emergency number; see our guide to emergency numbers in Spain.
Frequently asked questions
What is a normal LDL cholesterol?
There is no single normal value. For people at low risk, under 116 mg/dL (3.0 mmol/L) is a common target. People at higher risk have lower targets, such as under 70 or under 55 mg/dL.
How do I convert LDL from mg/dL to mmol/L?
Divide the mg/dL value by about 38.7. For example, 116 mg/dL is about 3.0 mmol/L and 190 mg/dL is about 4.9 mmol/L.
Do I need to fast for a cholesterol test?
Often not. Some labs still ask for a fast of 10 to 12 hours, mainly for triglycerides. Follow the instructions your lab gives you.
Can high LDL be inherited?
Yes. Familial hypercholesterolaemia causes high LDL from birth. Suspect it if LDL is about 190 mg/dL or more, or if close relatives had heart disease young.
Can an online doctor follow up high cholesterol if I live in Spain?
Yes. A GP licensed in Spain can review your history, lab reports and treatment questions by video. The doctor decides whether you also need a test or an in-person exam.
What should I bring to a cholesterol video visit?
Bring recent and earlier lab reports, your current medicine packaging and a list of concerns. Keep dates and units visible so each result can be read in context.
Can an online GP in Spain renew my statin prescription?
A prescription may be issued after a genuine clinical evaluation, where clinically appropriate, but renewal is never guaranteed. Any prescription is a private electronic prescription under Spanish law, dispensed in Spanish pharmacies.
Can I discuss results from a laboratory outside Spain?
Yes. Bring the original report with its date, units and lab details. The doctor converts the units and compares it with your Spanish results.
How often should I check my cholesterol?
It depends on your risk, your results and your treatment. Ask your doctor to set the next check for you rather than following someone else's timetable.
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
