Why the cholesterol target is lower once you have had an event, and what we are doing to reach it.

Your cholesterol after a heart attack, stroke or circulation problem

Why your target is different

Once you have had a heart attack, angina, a stroke, a mini-stroke, a stent, bypass surgery, or narrowing of the arteries in your legs, your arteries have already shown what they can do. The aim now is to stop it happening again.

That means we push your cholesterol lower than we would in someone who has never had an event, and we use a stronger dose to get there. This is not because anything has gone wrong. It is the standard plan for everyone in your situation.

The number we watch is your LDL cholesterol, sometimes called bad cholesterol. We aim to get it to 1.4 or below.

What we have done

Your text message says which of these applies to you.

Started or increased your statin

Usually Atorvastatin 80mg, one tablet once a day, which is the strongest routine dose. If you cannot take that, Rosuvastatin is the usual alternative. Take it every day at the same time. The new prescription has gone to your usual pharmacy, and the old strength should be stopped, so check the box you are given.

Added Ezetimibe

Ezetimibe 10mg once a day, alongside your statin, not instead of it. It works differently, by reducing the cholesterol you absorb from food, and it is well tolerated. Together they get most people to target.

Referred you for an injection treatment

If tablets alone have not got your cholesterol low enough, there are injection treatments given every few months. These are arranged through a specialist NHS service rather than here, and they will contact you directly. Carry on with your tablets in the meantime.

What you need to do

Take the tablet every single day. The protection only lasts while you take it.
Book a blood test 6 to 8 weeks after any change, and once a year after that.
Do not stop a tablet because of an ache without telling us. There is almost always a way round it.
Keep going with cardiac rehab or your exercise plan if you have one.
Do not smoke, and ask us for help if you want to stop.

Side effects and when to contact us

Contact the practice if you get:

new muscle pain, tenderness or weakness that does not settle, especially on both sides;
dark or cola-coloured urine, which means stop the tablet and contact us the same day;
yellowing of the skin or eyes, which means contact us urgently;
a new medicine started by anyone else, so we can check it does not interact.

Call 999 for chest pain at rest, chest pain that is not settling with your GTN spray, or sudden face, arm or speech changes. Do not wait to see if it passes.

More information

NHS.UKHeart attack: treatment and recoverychmg.co.uk/nhs-heart-attack - opens their website NHS.UKStatins: how they work and side effectschmg.co.uk/nhs-statins - opens their website British Heart FoundationLife after a heart attackchmg.co.uk/bhf-heart-attack - opens their website

Emergency? Chest pain at rest, or sudden face, arm or speech changes: call 999. Otherwise contact the practice.