Your GP record shows two things.First, you have heart or circulation disease.This is sometimes called cardiovascular disease. It usually means you have had a heart attack or a stroke. It can also mean you have had a procedure on your arteries, such as a stent or a bypass. Or you may have angina, or narrowed arteries.Second, your last blood test showed your LDL cholesterol is too high. LDL is the harmful type. Some people call it bad cholesterol.When both are true, you have a higher chance of another heart attack or stroke.There are treatments that lower that chance. We would like to talk to you about them. Then we can agree a plan that suits you.This is not only about statins. There are newer treatments on the NHS now. One is inclisiran. It is an injection you have twice a year. Another is ezetimibe, which is a tablet. These may suit you even if you have tried a statin and got on badly with it. So it is worth talking, whatever has happened before.Nothing has changed with your health. There is no new problem.This appointment is about lowering your risk from now on.

One of our senior clinicians will call you. They are experienced in treating high cholesterol, and they can prescribe medicines. The programme's clinical lead checks their work.It helps if you can:have your medicines to hand, or a list of thembe somewhere quiet where you can talk​​During the call they will:check your record is correctgo through your last cholesterol result, and what it meanstalk about what might helpagree a plan with yousort out the next steps​​What might help could be a new medicine. It could be a change to a medicine you already take. Or it could be support with food, activity, smoking or alcohol. Next steps might mean changing your repeat prescription. They might mean booking you in somewhere local for an injection. Or they might mean passing things back to your GP.Nothing will change without your agreement.If you want time to think, or to talk it over with someone first, that is fine.You may need a blood test before or after the call. We will tell you how to book one.

It depends on your record, and on what you want. Several medicines are approved for this by NICE. We can talk through the ones that might suit you.StatinsStatins lower the cholesterol in your blood. This helps prevent heart disease and stroke. They often work very well. They can cut your LDL cholesterol by around 30 to 50%.Your liver makes cholesterol. Statins slow that down. Your liver then takes cholesterol out of your blood instead, so your level falls.Like all medicines, statins can cause side effects. Most people get none. If you do get them, we can often try another statin, a lower dose, or a different medicine. Statins have been around a long time, and newer ones cause far fewer problems.EzetimbeEzetimibe is a tablet you take every day. Most people take it with a statin. Your gut takes in cholesterol from your food, and ezetimibe blocks some of that. On its own it lowers LDL cholesterol by 15 to 22%. With a statin, it lowers it by 21 to 27%.Most people have no trouble with it. A few get mild side effects, such as tummy pain, bloating, diarrhoea or wind.InclisiranThe NHS approved inclisiran in September 2021. It helps when other treatments, such as statins, have not lowered your cholesterol enough.A health professional gives it as an injection under the skin. After the first two doses, you have it every six months. It is a long-term treatment. You would need to keep having it to keep the benefit.Trials show inclisiran can lower LDL cholesterol by at least 50%. In those trials there were few side effects. The most common was a small skin reaction where the needle goes in.Other SupportWe can refer you to local services for help with food, activity, smoking or alcohol.If your case is more complicated, we can refer you to the specialist lipid clinic at Royal Berkshire Hospital, or talk to them about you.​If you have tried a statin before and stopped because of side effects, please still book. This is very common, and there are usually other options. We will not push you back onto something that did not suit you.

No. It is your choice, and you can change your mind at any time.If you do not book, nothing else changes. You will still get your usual care and your usual prescriptions from your GP.We would like you to book, because the evidence is strong that this lowers your risk. But it is your decision. If you would rather we did not contact you again, call0118 227 4995. We will note it on your file.

We work alongside your GP practice, not instead of it.everything we discuss is recorded in your GP recordyour GP practice will be sent a summary of the appointment and any changes we makeyour GP record stays the main record of your careonce your treatment is settled, your care goes back to your GP practice for the long term

You have not been singled out.We work closely with your GP practice to identify everyone in the same position as you: everyone who has had a cardiovascular event, and whose cholesterol is above the recommended level.NHS rules allow your record to be used to plan and provide your care. Your information is shared only between your GP practice and the local NHS teams involved in looking after you, under a formal information sharing agreement.We do not use your information for marketing, and we do not share it with anyone outside your NHS care team.You can read more in our privacy policy.

These charities give free, independent information about cholesterol. They are not part of this programme, but you can trust what they say. Their information is written for patients.HEART UK — the Cholesterol CharityBritish Heart FoundationInformation and support on heart and circulation conditions, including cholesterol treatments.Their Heart Helpline is staffed by cardiac nurses. Call 0808 802 1234 free, Monday to Friday, 9am to 5pm.

Interpreters - tell us when you book, or call us, and we will arrange an interpreter for your appointment.Other formats - we can send this information in large print, easy read, or another language.Someone with you -you are welcome to have a family member, friend or carer with you during the call.