Your risk of a heart attack or stroke is higher than we would like. This page shows what a statin would do for you, using NICE's own figures, so you can decide.

Deciding about a statin

Your GP has recommended a daily tablet called a statin, to lower your risk of a heart attack or stroke.

It is your choice. This page gives you the same numbers your GP uses, so you can weigh it up. When you have read it, answer the short questionnaire we sent. There is no wrong answer, and you can ask to talk it through first.

What your score means

We put your cholesterol together with your age, blood pressure, smoking, diabetes, kidney function and family history. That gives one number: your chance of a heart attack or stroke in the next 10 years.

If your score is 20%, that means: in a crowd of 100 people with the same score as you, we would expect 20 of them to have a heart attack or stroke over the next 10 years, and 80 not to.

Your text message from us has your score in it. Tap the one closest to your number and this page will use it.

Whatever you tap stays on your phone. This page cannot send anything anywhere, and we never see it.

What you can do without tablets

These lower your risk whatever you decide about the statin. They are not an either/or.

Do not smoke. If you smoke, stopping is the single biggest thing you can do.
Move more. Aim for 150 minutes a week of activity that leaves you a bit out of breath. Brisk walking counts.
Eat less saturated fat. Swap butter, fatty meat and pastry for olive or rapeseed oil, oily fish, nuts, beans and oats.
Keep to a healthy weight, or lose a little if you are above it.
Keep alcohol within 14 units a week.

For most people at your level of risk, these changes help but are not enough on their own. That is why we are also offering the tablet.

How much would a statin help you?

This is the part that matters most. Out of 100 people with your score, all taking a statin for 10 years:

7 out of 100 people with a 20% risk avoid a heart attack or stroke because they took a statin

7 avoid a heart attack or stroke because of the statin
13 have one anyway, despite the statin
80 would not have had one either way

These are NICE's figures, for 100 people with the same score as you over the next 10 years. We cannot say for sure what will happen to any one person.

Two things are worth noticing. A statin does not protect everyone: some people have a heart attack or stroke anyway. And most people would not have had one either way, so they take the tablet for years without ever knowing whether it helped. That is true of every preventive medicine.

What taking it involves

The tablet

Atorvastatin 20mg, one tablet once a day, at the same time each day, with or without food. This is the dose NICE recommends for people in your situation. It is one of the most widely used medicines in the world, has been in use for over 25 years, and costs the NHS a few pence a day. It goes on your repeat prescription, so you order it like your other medicines.

Blood tests

One blood test about 3 months after you start, to check your cholesterol has come down and that the tablet suits your liver. Then a routine check once a year. You do not need to fast for it.

How long for

The protection only lasts while you take it, so this is a long-term tablet rather than a course. That said, you can stop at any time, and you can change your mind in either direction. Nothing here is permanent.

What are the possible side effects?

Most people take a statin for years and notice nothing. Here is what the evidence actually shows, again out of 100 people.

Muscle pain

Out of 100 people who took a statin for a year

72 did not get muscle pain
26 got muscle pain, but would have got it anyway
2 got muscle pain because of the statin

Muscle pain caused by a statin usually shows up in the first year. Aches are very common in the general population, which is why most muscle pain in people on a statin turns out not to be caused by it. If you do get aches, tell us: we can test it properly by stopping the tablet for a few weeks and seeing what happens, then trying a lower dose or a different statin.

Severe muscle damage

This is the one people worry about, and it is rare. About 3 in every 10,000 people who do not take a statin get severe muscle damage anyway. If all 10,000 of them took a statin, on average an extra 3 people would get it. It shows up as severe muscle pain or weakness, or dark, cola-coloured urine. If that happens, stop the tablet and contact the practice the same day.

Type 2 diabetes

Out of 100 people who took a statin, in trials lasting about 4 to 5 years

95 did not get type 2 diabetes
4 got type 2 diabetes, but would have got it anyway
1 got type 2 diabetes because of the statin

This is more likely if you were already close to developing diabetes. Even if you do get it, the statin still lowers your risk of a heart attack and stroke.

Dementia

There is no good evidence that statins cause dementia.

Who should not take one

Statins are not used in pregnancy, when breastfeeding, or when you are trying for a baby. Tell us on the questionnaire if you have liver disease, drink more than 14 units a week, have had a problem with a statin before, or have unexplained muscle pain now. Some other medicines interact with statins; your GP checks your record for those before prescribing.

Making your decision

Before you answer the questionnaire, check how you feel about these four questions. If you answer no to any of them, tick "I would like to talk it through" and we will arrange a call.

Do you feel sure about the best choice for you?
Do you know the benefits and risks of taking a statin or not taking one, and about making changes to your lifestyle?
Are you clear about which benefits and risks matter most to you?
Do you have enough support and advice to make a decision?

What happens next

Answer the questionnaire we texted you.

Yes. If nothing on your record needs checking first, the prescription goes to your usual pharmacy and you will get a text explaining how to take it.
I would like to talk it through. We will arrange a telephone call with your GP.
No. We record your decision and leave it there. You can change your mind at any time, and we will not need to repeat your blood test unless it is over a year old.

When to contact us

Chest pain at rest, or sudden face, arm or speech changes: call 999. Chest pain on exertion or new breathlessness: contact the practice the same day.

More information

NICEShould I take a statin? The full decision aidchmg.co.uk/nice-statin-aid - opens their website NHS.UKStatins: how they work, side effects and how to take themchmg.co.uk/nhs-statins - opens their website British Heart FoundationHigh cholesterol explainedchmg.co.uk/bhf-cholesterol - opens their website

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