Your NHS journey

Who's who?

Meet the team whose help will be on offer:

1. Your GP

   The person you will see the most will probably be your GP who will monitor your symptoms and medicines. Your GP can also refer you to different healthcare professionals if needed.

2. Practice nurse

   If you need a blood test, it’s likely that this will be done either by the practice nurse in your GP’s surgery or by someone who specialises in taking blood samples, like a phlebotomist.

3. Dietitian

   You may be referred to a dietitian if your doctor thinks it’s necessary to help you switch to a healthier diet.

4. Hospital specialist

   Your doctor may refer you to a lipid clinic in the hospital if you have familial hypercholesterolemia (FH), other health problems such as diabetes, heart disease, chronic kidney disease or high blood pressure – or if your high cholesterol does not respond to a combination of lifestyle changes and medication.

Seeing your GP

Your doctor can help you reach your cholesterol and heart-health goals. And talking to your doctor is the first step. The more information you share with your doctor - about your lifestyle, your family history, and other risk factors - the better able you'll be to manage your heart health. Together, you and your doctor can set realistic goals to help manage your risk factors.

Your goals might include:

• Lowering cholesterol
• Losing weight
• Taking more exercise
• Quitting smoking

Be sure to talk with your doctor about your expectations. Keep in mind that it can't all be fixed in one visit. Managing cholesterol and working toward being heart healthy is an ongoing process.

Your treatment programme

Here's how your cholesterol management may work:

1. Once you've been diagnosed with raised cholesterol, you and your GP will talk about healthy lifestyle changes as well as medication to lower high cholesterol levels.
2. Your doctor may suggest a target cholesterol number for you. The optimum total cholesterol number is below 4mmol/L with LDL cholesterol below 2 mmol/L for people at risk of developing cardiovascular disease.
3. Your GP may prescribe a statin, the treatment of choice to manage high cholesterol. The choice of statin will depend on your medical history (whether you have other risk factors for a heart attack or stroke) and your cholesterol number. Remember to ask your doctor about any side effects that might happen with your medication.
4. Your doctor may ask you to come for a follow-up appointment around eight weeks after you begin treatment.  Tell your doctor if you have developed any unwanted side effects, particularly unexplained pain, tenderness or weakness in your muscles. If so, your doctor may need to change the type of statin you're taking - it may be a case of trying a couple of different ones until the right treatment is found for you.
5. It's vital to continue taking the cholesterol-lowering medication that your doctor has prescribed. If you're worried that you may be getting side effects from the treatment, don't stop taking it - instead, make an appointment to discuss your concerns with your GP.
   
   And when you get to your target...
   Don't stop your medication. Reaching a target is a great achievement, but maintaining your target levels is also essential.


6. Your doctor will want to review your progress regularly, at least once a year. Doctors often like to check on your progress when you have been taking your cholesterol-lowering medication for quite a while. You will also need to have regular blood tests to ensure that your cholesterol level is satisfactory.
7. Stick to healthy lifestyle changes including your diet, taking exercise, achieving a healthy weight and drinking only in moderation.
8. If your high cholesterol does not come down despite your combination of lifestyle changes and medication, your doctor may refer you to a hospital specialist. You will also be referred if you have familial hypercholesterolemia (FH), or other health problems such as diabetes, heart disease, chronic kidney disease or high blood pressure.

If you’re at high risk

Many people, who have experienced a heart attack or stroke, or are at high risk of developing cardiovascular disease such as people with Diabetes, may have been put on medication regardless of their cholesterol level, because their risk of having further complications is high.

Your GP or hospital specialist will want to review your progress at follow-up appointments, and may request a blood test to check that your cholesterol levels are staying within the optimum range. Tell your doctor if you've been experiencing any unwanted side effects of your medication, as it may be that a different statin will suit you better.

Remember, it's important that you continue with your healthy lifestyle approach and your doctor will probably talk with you about how you're getting on with these.

Finding what’s right for you

Certain treatments for cholesterol may be more appropriate for you than others. You can discuss the different medicines with your doctor and decide together which one is right for you.

If you and your doctor decide to swap to a different treatment - for example, if the first choice is giving you side effects - it is very important to be certain that the new medication is still keeping your numbers within the right targets. You may like to ask your doctor whether you should have another cholesterol test. He or she will consider your particular circumstances and risk factors, but it's the only way to discover what effect your medication is having on your cholesterol numbers and find out if you are still on target.

Once you have found a treatment that you are both happy with and that helps you to keep your cholesterol numbers on target, stick at it! To stay on target, it is very important to carry on taking the medicine your doctor has prescribed. Maintaining your cholesterol at target levels will bring long-term benefits, helping you to avoid serious risks to your health.