Tudor Lodge Surgery
Your blood test gives us one part of a bigger picture. Put together with a few other things we know about you, it tells us your chance of a heart attack or stroke in the next 10 years.
How the score is worked out
A cholesterol level on its own says little about your heart. What matters is how it sits alongside your age, your blood pressure and the rest of your medical history.
We put all of it into a calculator called QRISK3. It is used across the NHS for people aged 25 to 84 who have not already had a heart attack or stroke.
The score it gives is not a diagnosis, and it is not a prediction about you as an individual. It tells us whether treatment is likely to be worth it.
Your risk, shown as 100 people
About 10 in 100 people with your score would be expected to have a heart attack or stroke in the next 10 years. 90 would not.
At this score we would offer you a statin, usually atorvastatin 20 mg, alongside the changes further down this page. Whether you take it is your decision.
A statin is offered from 10% upwards.
Your number is in the letter or message we sent you. If you cannot find it, ask us. If your score is below 8%, the benefit from a statin is smaller again, and worth talking through.
The part most people want to know
Switch the diagram above between “No statin” and “Taking a statin” to see it change.
They are taken directly from the NICE patient decision aid Should I take a statin?, which publishes a diagram for each of these risk scores. Like the decision aid, use the score nearest to your own. The figures are modelled on a high-intensity statin, which is what atorvastatin 20 mg is.
They are averages for 100 people, not a forecast for you. Some people who take a statin will have a heart attack or stroke anyway, and some who take one would never have had one. Nobody can say which.
Of those 10, about 4 people in 100 would avoid a heart attack or stroke because they took a statin. The other 6 would have one anyway.
Without a prescription
These help almost everyone, whatever the score. If you would rather try them before considering tablets, that is reasonable. We can repeat your cholesterol and work the score out again in 6 to 12 months.
Our stop smoking advisers can help, and so can your local pharmacy.
Less saturated fat: butter, pastry, fatty and processed meat, hard cheese. More fibre, five portions of fruit and vegetables, and oily fish twice a week.
Enough to leave you slightly out of breath. A regular short walk counts.
Spread across three days or more, with some days free of it altogether.
If your background is South Asian, Chinese, Black African or African-Caribbean, the healthy range is lower and risk begins to rise from about 23.
Usually needs medication as well as the changes above.
Statins
One tablet a day. Most people notice nothing.
A statin lowers your cholesterol, and lower cholesterol means fewer heart attacks and strokes.
If your score is 10% or more, national guidance says we should offer you atorvastatin 20 mg. If it is under 10% and you would still like to take one, we can discuss it.
The commonest worry is muscle aches. If you get muscle pain, tenderness or weakness after starting, tell us rather than stopping on your own. There is a blood test we can do, and there is often another explanation.
Statins should not be taken in pregnancy or while trying for a baby.
If one statin does not suit you, another one often does.
Another 26 in 100 get muscle pain while taking one, but would have had it anyway. The remaining 72 get none.
A further 4 in 100 develop it while taking one, but would have done regardless. Even then, the statin still lowers your heart risk.
Rare. It happens to about 3 in every 10,000 people who take no statin, and to about 3 more per 10,000 who do.
Figures from the NICE decision aid.
Monitoring
Starting a statin is not a one-off. These are the checks we build in.
A blood test for your cholesterol and your liver. We want your non-HDL cholesterol to have fallen by more than 40%.
One further liver check, and a look at where your cholesterol has settled.
A medication review and a cholesterol check.
Exceptions
For some people the calculator is the wrong tool, because we already know the risk is raised. That applies to anyone with type 1 diabetes, moderate or severe kidney disease, familial hypercholesterolaemia or another inherited cholesterol condition, or a previous heart attack, stroke, angina or narrowed arteries in the legs.
If you are 85 or over, age alone already places you at increased risk, so the decision is made differently.
In all of these situations, please speak to us rather than relying on a number from a web page.
Chest pain, tightness or heaviness lasting more than 15 minutes. Or sudden weakness in the face or one arm, or slurred speech. Do not wait, and do not contact the surgery first.
Next step
If you have questions, or you want to talk through whether a statin is right for you, get in touch and we will book the time.