Healthy changes
- eat less saturated fat and more fruit, vegetables, wholegrains, beans, nuts and oily fish
- be active for at least 150 minutes a week
- stop smoking, and keep alcohol within 14 units a week
- lose weight if you need to
Statins
Statins lower LDL cholesterol and reduce the chance of a heart attack or stroke. They are among the most studied medicines in the world. Your GP will usually offer one if:
- your QRISK score shows a 10% or higher chance of a heart attack or stroke in the next 10 years
- you already have heart or circulation disease
- you have type 1 diabetes, chronic kidney disease or familial hypercholesterolaemia
Statins are usually taken for life. You will have blood tests to check your cholesterol and liver.
Other medicines
If a statin is not suitable, or does not lower cholesterol enough, you may be offered:
- ezetimibe, a tablet that stops your gut absorbing cholesterol
- bempedoic acid, a tablet
- inclisiran, an injection twice a year, given at your GP surgery
- PCSK9 inhibitors, injections usually started by a specialist
Familial hypercholesterolaemia
If you have FH, you should be referred to a specialist, and your close relatives should be offered testing.
Common questions
Do statins cause muscle pain?
Some people get aches while taking statins, but large studies show most of these aches are not actually caused by the statin. If you have muscle pain, talk to your GP. Changing the dose or type of statin often helps.
Sources we used
- NICE guideline NG238, Cardiovascular disease, risk assessment and reduction
- NHS, Statins
- HEART UK, Cholesterol lowering treatments
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