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PATIENT INFORMATION

Cholesterol after a heart attack or stroke

Once your arteries have caused a problem, we aim your cholesterol lower than we would in someone who has never had one.

Why your target is different

This page is for you if you have had any of these:

Your arteries have already shown what they can do. The aim now is to stop it happening again.

So we aim your cholesterol lower than we would in someone who has never had a problem. We use a stronger dose to get there.

Nothing has gone wrong. This is the standard plan for everyone in your situation.

Information:

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 names one of these.

Started or increased your statin

Usually Atorvastatin 80mg, one tablet a day. This is the strongest routine dose. If you cannot take it, Rosuvastatin is the usual alternative.

Take it every day at the same time. Check the box your pharmacy gives you, because the old strength stops.

Added Ezetimibe

Ezetimibe 10mg once a day, alongside your statin rather than instead of it.

It works differently, by reducing the cholesterol you absorb from food. 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 injections given every few months.

A specialist NHS service arranges these, not us. They will contact you directly. Keep taking your tablets while you wait.

What you need to do

Do

  • take the tablet every single day, because the protection lasts only while you take it
  • book a blood test 6 to 8 weeks after any change, then once a year
  • keep going with cardiac rehab or your exercise plan if you have one
  • get help to stop smoking if you smoke

Do not

  • do not stop a tablet because of an ache without telling us, because there is almost always a way round it

Immediate action required: Call 999 now if you have:

  • chest pain at rest, or chest pain that your GTN spray does not settle
  • sudden weakness or numbness in the face or one arm
  • sudden trouble speaking or understanding speech

Urgent advice: Stop the tablet and contact the surgery the same day if you have:

  • dark or cola-coloured urine
  • severe muscle pain or weakness, or trouble climbing stairs
  • yellowing of your skin or the whites of your eyes

More information

NHS.UKHeart attack: treatment and recoverywww.nhs.uk/conditions/heart-attack/ NHS.UKStatins: how they work and side effectswww.nhs.uk/medicines/statins/ British Heart FoundationLife after a heart attackwww.bhf.org.uk/informationsupport/conditions/heart-attack

Reviewed 26 August 2026 ยท next review 26 February 2027