The NHS has shared some key lifestyle changes your GP might recommend before putting you on medication. These recommendations could be suggested before trying statins, one of the most commonly prescribed drugs in the UK.

Statins are a group of drugs that can reduce the level of low-density lipoprotein (LDL) cholesterol, also referred to as “bad” cholesterol, in the blood. Having too much LDL cholesterol can be dangerous as it can cause the arteries to narrow and harden.

It is also a major risk factor for cardiovascular disease, the name for a number of conditions related to the heart and circulatory system including heart attacks, strokes, angina, and coronary heart disease. It is one of the leading causes of death in the UK.

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On the NHS website, the health body said a doctor may recommend taking statins if either you have been diagnosed with a form of cardiovascular disease or your personal and family medical history suggests you're likely to develop CVD at some point over the next 10 years and lifestyle measures have not reduced this risk.

Before trying statins though, your doctor will “usually” recommend you make some changes. The NHS said: “If you're at risk of developing cardiovascular disease in the near future, your doctor will usually recommend lifestyle changes to reduce this risk before they suggest that you take statins.”

According to the NHS, these can “reduce your cholesterol level and cardiovascular disease risk”. These changes are:

• Eating a healthy, balanced diet


• Exercising regularly


• Maintaining a healthy weight


• Limiting the amount of alcohol you drink


• Stopping smoking

But the NHS said: “Statins may be recommended if these measures do not help.”

Diet

The health body said you should try to cut down on fatty food, especially food that contains a type of fat called saturated fat. “You can still have foods that contain a healthier type of fat called unsaturated fat,” it said.

Therefore, you should try to eat more:

• Oily fish, like mackerel and salmon


• Olive oil, rapeseed oil and spreads made from these oils


• Brown rice, wholegrain bread and wholewheat pasta


• Nuts and seeds


• Fruits and vegetables

And you should try to eat less:

• Meat pies, sausages and fatty meat


• Butter, lard and ghee


• Cream and hard cheese, like cheddar


• Cakes and biscuits


• Food that contains coconut oil or palm oil

Exercise

The NHS said you should aim to do at least 150 minutes (2.5 hours) of exercise a week.

Stop smoking

The NHS said: “Smoking can raise your cholesterol and make you more likely to have serious problems like heart attacks, strokes and cancer.” If you want to stop smoking, you can get help and support from your GP or the NHS Stop Smoking Service – your GP can refer you or you can ring the helpline on 0300 123 1044 (England only).

Alcohol

The NHS said you should:

• Avoid drinking more than 14 units of alcohol a week


• Have several drink-free days each week


• Avoid drinking lots of alcohol in a short time (binge drinking)

What is considered high cholesterol?

The only way to be sure if your cholesterol levels are too high is to take a cholesterol test. These will confirm your:

• Total cholesterol – the overall amount of cholesterol in your blood


• Good cholesterol (called HDL) – this may make you less likely to have heart problems or a stroke


• Non-HDL cholesterol – the difference between total cholesterol and HDL

The NHS explained: “What is a good target level for you depends on things like your age, whether you have any health conditions and your risk of cardiovascular disease.” But generally, the following levels are considered “healthy”:

• Total cholesterol - below 5mmol/L


• HDL (good cholesterol) - above 1.0mmol/L for men or above 1.2mmol/L for women


• Non-HDL (bad cholesterol) - below 4mmol/L