Cholesterol care

Cholesterol is a fatty material in your blood which is mainly made in the liver. It plays an important role in how our cells work and helps your body make vitamin D and hormones which keep your bones, teeth and muscles healthy.

Having too much cholesterol can clog your arteries, causing problems like heart disease. There are two main types of cholesterol:

  • ‘good cholesterol’ (called high-density lipoproteins or HDL) which take cholesterol you don’t need back to the liver
  • ‘bad cholesterol’ (called non-high-density lipoproteins or non-HDL) which can lead to fatty layers building up in your arteries that block the flow of blood to and from the heart. This can increase your risk of getting heart problems.

Understand your cholesterol test results including:

  • Total cholesterol
  • Non-HDL cholesterol
  • HDL cholesterol
  • TC:HDL ratio
  • Triglycerides

Why do you need to bring your cholesterol down?

There is a lot of evidence for patients who have ischaemic heart disease (angina or previous heart attack), transient ischaemic attack (TIA) or stroke or peripheral vascular disease to lower cholesterol. NICE recommends lipid lowering therapy in this group of patients as part of secondary prevention of cardiovascular disease.

NICE also recommends lipid lowering therapy for patients at higher risk of developing cardiovascular disease eg heart attack or stroke or death (primary prevention). QRISK3 is a tool to identify what your 10 year risk may be.

How do I lower my cholesterol ? Your top 5 questions answered

Most people are offered statins to reduce cholesterol if your risk of having a cardiac event are deemed high.

“On average, statins can reduce the risk of a heart attack by approximately 25-35%”

Dr Amir Hannan

How to take statins

Statins come as tablets that are taken once a day. The tablets should normally be taken at the same time each day – most people take them just before going to bed.

In most cases, treatment with statins continues for life, as stopping the medication causes your cholesterol to return to a high level within a few weeks.

If you ever forget to take your dose, don’t take an extra one to make up for it. Just take your next dose as usual the following day.

What follow up is needed after starting statins ?

After starting treatment you should have a blood test within 3 months and again at 12 months. The blood test is to check that the liver has not been affected by the medication. The blood may also be checked to measure the cholesterol level to see how well the statin is working.

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What else can you do ?

  • It is important to take your medicine daily and never forget to take it.
  • Use the NHS app (or equivalent app eg Patient Access or Evergreen life PHR) to order your repeat prescriptions online. Add a reminder on your phone or ask for proxy access so that somebody you trust can order it for you. You can order your prescriptions up to 1 week before it is due so that you have ample time to get it from the pharmacy
  • Monitor your weight, blood pressure and mood via the My GM Care app
  • Speak to your doctor or nurse if you have problems with any medication and think you may be getting side effects. We are here to help you. Do not stop the medication without speaking to us as we may be able to advise you on what else to do eg lower the dose of tablet, change to another tablet or offer an alternative.

How else to lower your cholesterol and triglycerides

Further information

Getting treatment to help reduce your cholesterol

Learn more about statins

Statins – your questions answered

Reducing your high cholesterol

How do statins prevent heart attacks and strokes?

Side effects from statins could be all in the mind

Alternatives to statins

The most widely used medicine to lower cholesterol is a statin, but there are other medicines available too and some may only be prescribed in a specialist lipid clinic

Learn more about ezetimibe, bepedoic acid, inclisiran and other drugs and treatments

How does cholesterol affect the heart?