Lipids Information

Why have I been sent this link?

You recently had a blood test to measure your cholesterol. As you may know, the amount of cholesterol in your blood can increase your risk of developing cardiovascular disease (CVD) which includes heart attack, stroke and peripheral vascular disease.

However, cholesterol is only one risk factor for CVD and using information from your medical record we can use the QRISK2/3 tool to calculate the likelihood of you having a stroke or heart attack in the next 10 years. The higher the score, the greater the risk. Also, the more risk factors you have, the greater your risk.

Other risk factors for CVD include:

  • Age, gender, ethnicity
  • High blood pressure, cholesterol level, body mass index (height and weight),
  • Smoking, alcohol intake
  • Medical conditions such as diabetes, rheumatoid arthritis, chronic kidney disease
  • Strong family history of heart disease (in relatives under 60 years)

What does ‘risk’ mean?

Risk is the chance of something happening. It’s important to note that your risk of developing CVD is never zero and regardless of other risk factors, your risk naturally increases the older you get.

Your QRISK score will tell you whether you are at low, moderate or high risk of developing CVD in the next 10 years.

Low risk – QRISK 2/3 score of less than 10%

This means that you have less than a one in ten chance of having a stroke or heart attack in the next 10 years.

Moderate risk – QRISK 2/3 of 10-20%

This means that you have between a one to two in ten chance of having a stroke or heart attack in the next 10 years.

High risk – QRISK 2/3 score of more than 20%

This means that you have at least a two in ten chance of having a stroke of heart attack in the next 10 years

What can I do to lower my risk?

Guidance from NICE (National Institute for Health and Care Excellence) suggests that anyone with a score of more than 10% (moderate risk) should be offered help to reduce their risk. This includes advice on making lifestyle changes and we offer the option of starting medication to lower cholesterol (statins).  In January 2023, NICE told us they are reducing the threshold for starting statins and are now advising that we offer statins to patients with a QRISK score of more than 5%.

What lifestyle changes can I make?

You may have noticed that the list of risk factors includes things we can change (such as smoking  status, weight and blood pressure) and things we cannot change (such as age and gender). We can therefore try to reduce our risk by taking a few simple steps including:

  • Stop smoking
  • Eat a healthy balanced diet – low in fat, sugar and salt. Eat 5 fruit / veg a day.
  • Reduce alcohol intake – aim for less than 14 units a week for men and women.
  • Keep an eye on your weight and take steps to lose weight if needed. Aim for BMI 20-25.
  • Exercise regularly (walking is a great start).
  • Taking medication to reduce blood pressure if needed.

It is very likely that you will benefit from changes to your lifestyle (regardless of risk). However, we can test your cholesterol level again in 6-12 months, measure your weight, height and blood pressure and recalculate your QRISK 2/3 score. Further information about how you can make lifestyle changes can be found here: Live Well – NHS (www.nhs.uk)  or Healthy eating - reduce your risk of developing heart disease - BHF

For more information to understand cholesterol we recommend looking at the British heart foundation leaflet u003-understanding-cholesterol_download-0818.pdf (bhf.org.uk)

What are statins?

Statins are a group of medications that help to reduce cholesterol which in some cases can lower your risk of heart attack and stroke by up to 25%. Statins are designed to be taken every night and are generally considered to be safe. However as with any medication, unwanted side effects can occur.

Please see the NHS statins website for further information about statins and take a look at this for help in making a decision: Cardiovascular disease: risk assessment and reduction, including lipid modification (nice.org.uk)  If you then wish to start the Statin then reply to the text sent or if you wish to discuss further submit an Econsult to discuss with a Clinical Pharmacist.

Please also see this useful educational video