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Get back in the game is a Novartis disease awareness campaign, funded by Novartis Pharmaceuticals UK Ltd. and developed in collaboration with HEART UK. HEART UK has provided expertise in the development of this campaign and hosting of this platform. Novartis has approved the associated materials in line with the Association of the British Pharmaceutical Industry Code of Practice.

ChetanBack on the pitch following
a heart attack in 2017
Get back in the game Keep on top of cholesterol

High LDL (bad) cholesterol is a major cause of cardiovascular events such as a heart attack or strokes.3

If you have already experienced an event, keeping on top of your cholesterol is more important than ever.1-4

Speak to your doctor, nurse or pharmacist about testing and managing your cholesterol levels.

Having a heart attack or stroke can be scary and it can leave you wondering why it happened and what you can do to prevent it from happening again.

The good news is, you could cut the risk of another cardiovascular disease (CVD) event by making some lifestyle changes to help lower your cholesterol levels, and working with your doctor, nurse or local pharmacist to ensure you are on the most appropriate management plan for you.1–4

Though it is indeed possible to not only survive but also recover from a heart attack or stroke, it is important that you are aware of the risks factors and are working towards reducing your chances of another CVD event.5-8

Now is the time to get back in the gamecheck your LDL and know your level

The Get Back in the Game campaign aims to drive awareness of cholesterol as a major risk factor for CVD, as well as providing information and useful resources to support people who have experienced a cardiovascular event with the management of their cholesterol levels.

See how the campaign was brought to life in our ‘making of Get Back in the Game’ video:

Hear the real-life stories of Chetan and Lisa, two inspirational individuals who are living with CVD, and managing their cholesterol levels to ensure they can ‘Get Back in The Game’ and live full, active lives.

We also teamed up with cricketing legend Phil Tufnell to highlight that managing your cholesterol is key to maintaining heart health following a heart attack or stroke. After launching our ‘Get Back in the Game’ campaign with Phil and ITN Business, we took Phil across the nation, testing cricket fans on their cholesterol knowledge and raising awareness on the importance of cholesterol management. Following this, Phil brought his old teammate Mark Ramprakash back to their roots to meet the Middlesex Seniors Cricket team and hear from some of the players about how managing their cholesterol helped them to get back in the game after experiencing a heart attack.

What is Cardiovascular disease?

LisaJogging through life following
bypass surgery in 2016

Cardiovascular disease (CVD) is a general term for a family of conditions with common risk factors that affect the heart or blood vessels. It is usually the result of a build-up of fatty material inside the arteries (also known as atherosclerosis).9,10
If you have already had a heart attack or stroke, it is more important than ever to have your cholesterol levels checked regularly, at least once a year or more frequently if advised by your healthcare professional.11,12

The different types of CVD include:9,10

Coronary heart disease (CHD)

Stroke

Peripheral arterial disease (PAD)

CVD Causes

You can help reduce your chances of another heart attack or stroke by understanding what led to the first one.14 Though it is not yet clear what exactly causes CVD, there are many things that can increase your risk of developing it.9,10 By being aware of and managing the factors that are linked to the way you live your life, such as high cholesterol, you could help lower your risk of future CVD events.1,2,4,14

CVD risk factors

Factors that are linked to the way you live your life (known as modifiable risk factors) include:15

Other risk factors, that cannot be changed, include your family history, age and ethnic origin.15

Cholesterol & CVD

What is cholesterol?

Cholesterol is complicated. If you’ve had a cardiovascular event, you’ll be even more keen to understand what’s going on inside your body so you can keep your cholesterol levels in check. Cricket legend, Phil Tufnell explains in this short animation the importance of having your cholesterol levels checked and how to help lower the risk of ‘The Silent Enemy’, creeping up on you. Watch the animation below to learn more.

More on cholesterol

Click here

There are two main types of cholesterol:16

We all need both types of cholesterol in our bodies, but when levels of LDL get too high, it can be bad for our heart health.16

Though having high cholesterol does not usually cause any symptoms, it can block your blood vessels and significantly increase your risk of having a heart attack or stroke, especially if you’ve had one before.10 This makes checking and improving your cholesterol levels key in helping you manage your CVD and reducing your risk of having another event.3,4,11

Remember, anyone can have high cholesterol, whether you’re young, slim, or even otherwise healthy. You can’t feel it, so the only way to find out your cholesterol levels is to see your doctor, nurse or pharmacist and get them checked, especially your LDL.17

Find what happens if your arteries become clogged up with cholesterol

Click here

Checking Cholesterol

A cholesterol check involves a simple blood sample and the results can include different types of cholesterol, however, the one that you need to particularly focus on when looking to reduce the risk of another CVD event is usually your LDL (bad) cholesterol level.4,12

A cholesterol test can be done in two ways:12

A finger prick test:

It’s quick and you only feel a small pinch – the results can be checked there and then.

A blood test:

A small sample is taken from your arm using a needle and syringe which will be sent off for testing.

Speak to your doctor, nurse or pharmacist about what you can expect from your cholesterol test and whether you need to fast for it.

It is important that your test results are explained to you as it will give you a good idea of your heart health and whether your current lifestyle and management plan is working for you.12,18 Ask your doctor to explain more about what your cholesterol results mean and provide a full breakdown of the different types of cholesterol and what levels you should be aiming for.

To discover more about each of the types of cholesterol in your blood, you can read more about each one here

What do your cholesterol results mean?

Blood cholesterol is measured in units called millimoles per litre of blood, often shortened to mmol/L. If you are considered at higher risk, due to already having experienced a cardiovascular event, please refer to the table below for the levels the NHS advises aiming for:

Recommended target levels for those who’ve had a cardiovascular event19

Total cholesterolLower than 5.0 mmol/L
Non-HDL cholesterolLower than 2.5 mmol/L
LDL cholesterolLower than 1.8 mmol/L

Speak to your doctor, nurse or pharmacist if you haven’t had a cholesterol test in the last 12 months and ask them to explain your levels so you know what you need to do to keep on top of cholesterol and get back in the game.

Please note these targets are specifically for people already living with cardiovascular disease. Target levels for healthy adults differ.

A general guide for recommended cholesterol levels for a healthy adult can be found here

Guide for recommended target cholesterol levels

Where can I get a Cholesterol check?

You can get tested by:12

  1. Visiting your GP practice
  2. Getting a NHS Health Check
  3. Visiting your local pharmacist

Learn more about getting a NHS Health Check

Click here

Learn more about getting a cholesterol test

Click here

Managing Cholesterol

Healthy Eating for Cholesterol Management

For those who have had a cardiovascular event such as a heart attack or stroke, cholesterol-lowering medications are usually needed to control cholesterol levels. It’s also important to have a healthy balanced diet to help manage cholesterol, as well as overall health. This includes eating a wide variety of foods in the right proportions. Follow our top tips to help you achieve this.

The following nutritional guidance has been provided by HEART UK’s qualified Dietetic Advisor, Lynne Garton:

1. Cut down on foods high in saturated fat and replace them with foods higher in unsaturated fat.

Opt for simple swaps to replace foods high in saturated fat with healthier options, like swapping butter for spreads made from vegetables and seeds such as olive, rapeseed, sunflower and soya oil. Find more healthier swaps on the HEART UK website.

Remember, all types of fat are high in calories and should be eaten sparingly, especially if you are managing your weight.

2. Eat at least 5 portions of a variety of fruit and vegetables every day.

  • These can be fresh, frozen, tinned or dried
  • Include with every meal e.g., a handful OR a tablespoon of dried fruit with breakfast cereals or porridge, salad vegetables with lunch, a piece of fruit as a snack and 2 servings of vegetables with a main meal
  • Keep it colourful – RED, ORANGE, YELLOWS and GREENS

3. Choose wholegrain and high fibre starchy foods and include them at every meal.

Whole grains include wholemeal bread, rolls, wraps, tortillas, chapatti, whole grain breakfast cereals, oats/porridge, brown rice, wholewheat pasta. Choose these instead of the refined, ‘white’ varieties. Read more about wholegrains on the HEART UK website.

4. Have some low fat dairy or fortified dairy alternatives, such as soya drinks and dairy alternatives to yogurts.

  • Choose lower sugar options if available
  • Avoid coconut drinks and coconut yogurt alternatives as these can be high in saturated fat
  • Even lower fat cheeses can be high in saturated fat, so watch how much you eat. Very low fat hard cheeses or quark and cottage cheese provide very little saturated fat and can be eaten more freely

5. Choose healthy sources of proteins.

  • Include more plant proteins into your diet such as beans, peas, lentils, soya mince, Quorn™ and nuts
  • Aim for 2 portions of fish every week, 1 of which should be oily, such as sardines, pilchards, salmon or mackerel
  • If meat is eaten, choose lean cuts and watch the quantities
    • Remove skin from chicken
    • Have red meat less frequently and watch your portions – one serving should be no more than 70g (the size of your palm)
    • Swap some, or all, of the meat in recipes with beans, lentils, soya or Quorn™
    • Try and go meat free a couple of days a week
  • Avoid processed meat like bacon, ham and sausages

6. Cut down on foods high in fat (particularly saturated fat), salt and added sugars.

  • These aren’t needed in our diet, so should be eaten less often and in smaller amounts
  • This includes most highly processed foods e.g. savoury snacks, sweets, chocolates, pastries, cakes, biscuits, ready meals, take-aways and processed meats etc.
  • Cook from scratch more often so you know exactly what you’re eating
  • When you’re shopping, check the label on the front and go for ‘green’ for saturated fat and salt
  • Instead of sugary drinks, choose unsweetened varieties including tap, bottled and ‘sugar-free’ flavoured waters; teas/coffees made with low fat milk or plant-based drink and no added sugar or syrups; diet/sugar-free soft drinks

7. Eat the right quantities to maintain a healthy weight.

8. If you choose to drink alcohol, drink within sensible limits.

No more than 14 units a week.

Once you have achieved these healthy foundations, there are other foods that can be included into your diet which have further cholesterol lowering benefits. Find out more in HEART UK’s Ultimate Cholesterol Lowering Plan (UCLP©).

I’m taking medication, why do I still need to keep an eye on my cholesterol?

Some peoples’ cholesterol levels are not controlled properly, despite being on lipid-lowering medication, leaving them at an increased risk of another heart attack or stroke.11,20,21

Catching raised cholesterol early can ensure optimal management, whether you’ve just been diagnosed with CVD, or have previously had a heart attack or stroke.1,3,4,11

If you’re currently on a treatment to control your cholesterol, you should still be having your levels checked every year, or more frequently, depending on how stable your condition is.11,12

Even if you have been prescribed lipid-lowering medication, you may need additional care to ensure that your cholesterol is managed properly, helping you stay at the top of your game.11,12,20,21

Speak to your doctor, nurse or pharmacist about managing cholesterol to help reduce the risk of another CVD event.

Your cholesterol Q&A

We’d really like to understand a bit more about how much people know about cholesterol.

Please take a moment to complete the following - it’s completely anonymous so none of your personal data is stored. All responses will be pooled together and the collective results will be shared by HEART UK with Novartis for their information.

Q1:

Before arriving here today did you know the difference between good (HDL) cholesterol and bad (LDL) cholesterol?

Q2:

Were you aware that high levels of bad (LDL) cholesterol can increase the risk of a cardiovascular event such as a heart attack or stroke?

Q3:

Did you know that if you’ve had a cardiovascular event, and whether or not you’re on treatment to manage your cholesterol, you should be getting your cholesterol levels checked at least every year?

Q4:

As a result of your visit here today, are you, or is someone you know or care for, more likely to discuss how to manage cholesterol with a healthcare professional?

Submit

Thank you for completing our quick questionnaire.

The information provided on this web page is intended for general information purposes only. Information concerning any product is not intended to provide, or substitute, medical advice. This web page is in no way intended to offer medical diagnosis or patient-specific treatment advice. If you have a medical condition you should promptly see a medical doctor or healthcare provider.

If you get side-effects with any medication you are taking, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the information leaflet that comes in the pack. You can report side effects via the Yellow Card Scheme at https://yellowcard.mhra.gov.uk/ (UK). By reporting side effects you can help provide more information on the safety of your medication.

References

  1. Sabatine MS, et al. Efficacy and safety of further lowering of low-density lipoprotein cholesterol in patients starting with very low levels. JAMA Cardiol. 2018;3(9):823–828.
  2. Ference BA, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the EASC Panel. European Heart Journal 2017;38:2459–2472.
  3. Packard C, et al. Intensive low-density lipoprotein cholesterol lowering in cardiovascular disease prevention. Heart 2021;107(17):1369–1375.
  4. Mach F, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J 2020;41(1):111–188.
  5. National Health Service (2019). Heart attack: Recovery. Available at: https://www.nhs.uk/conditions/heart-attack/recovery/. Accessed: August 2023.
  6. National Health Service (2019). Stroke: Recovery. Available at: https://www.nhs.uk/conditions/stroke/recovery/. Accessed: August 2023.
  7. British Heart Foundation. Heart statistics: BHF Statistics Factsheet - UK (pdf). Available at: https://www.bhf.org.uk/what-we-do/our-research/heart-statistics. Accessed: August 2023.
  8. Bhatnagar P, et al. Trends in the epidemiology of cardiovascular disease in the UK. Heart 2016;102:1945–1952.
  9. National Health Service (NHS 2022). Cardiovascular disease. Available at: https://www.nhs.uk/conditions/cardiovascular-disease/ Accessed: August 2023.
  10. HEART UK (2018). State of the nation: Cardiovascular disease. Available at: https://www.heartuk.org.uk/downloads/heart-uk-state-of-the-nation-report-2018.pdf. Accessed: August 2023.
  11. HEART UK (2021). The future of CVD care in an evolving system. Available at: https://www.heartuk.org.uk/downloads/heart-uk---future-of-cvd-care-report.pdf. Accessed: August 2023.
  12. HEART UK. Getting a cholesterol test. Available at: https://www.heartuk.org.uk/cholesterol/getting-a-cholesterol-test. Accessed: August 2023.
  13. HEART UK. What is high cholesterol. Available at: https://www.heartuk.org.uk/cholesterol/what-is-high-cholesterol. Accessed: August 2023.
  14. Chest Heart & Stroke Scotland. Understanding the need for changes after a heart attack. Available at: https://www.chss.org.uk/documents/2014/08/f39-understanding-the-need-for-changes-after-a-heart-attack-pdf.pdf. Accessed: August 2023.
  15. National Institute for Health and Care Excellence (NICE 2020) CVD risk assessment and management: What are the risk factors? Available at: https://cks.nice.org.uk/topics/cvd-risk-assessment-management/background-information/risk-factors-for-cvd/. Accessed: August 2023.
  16. HEART UK. What is cholesterol? Available at: https://www.heartuk.org.uk/cholesterol/what-is-cholesterol. Accessed: August 2023.
  17. HEART UK. Cholesterol. Available at: https://www.heartuk.org.uk/cholesterol/overview. Accessed: August 2023.
  18. HEART UK. Understanding your cholesterol test results. Available at: https://www.heartuk.org.uk/cholesterol/understanding-your-cholesterol-test-results-. Accessed: August 2023.
  19. NHS England. Quality and Outcomes Framework guidance for 2023/24. Available at: https://www.england.nhs.uk/wp-content/uploads/2023/03/PRN00289-quality-and-outcomes-framework-guidance-for-2023-24.pdf. Accessed August 2023
  20. Ray KK, et al. EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: the DAVINCI study. European Journal of Preventive Cardiology 2021:28;1279–1289.
  21. Akyea KP, et al. Sub-optimal cholesterol response to initiation of statins and future risk of cardiovascular disease. Heart 2019;105:975–981.

UK | August 2023 | 218588-2

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