This area of our website is for healthcare professionals only

Please click below to declare your professional status:

YES, I am a healthcare professional  NO, I am not a healthcare professional

Primary care resource centre

If you work in Primary Care, this area will give you information and resources to help you manage your patients with altered lipid profiles. You can also download the guidance from NHS England below, to support your practice and decision-making.

Do you provide dietary advice for lipid management?


Download our cardiovascular diet checklist to help you assess the quality of your patient's diet.

LDL-C and non HDL-C: Why do we use different readings when managing lipids?

LDL-C is the main lipid risk factor for atherosclerotic cardiovascular disease (CVD) reported in clinical trials.

LDL-C is calculated by the laboratories using the Friedewald formula: total cholesterol minus HDL-C level minus (triglyceride divided by 2.2) in mmol/l.

As triglyceride levels in particular are much more affected by fasting or non fasting, this can affect the calculated LDL-C level but fasting does not significantly affect the total cholesterol or HDL-C level.

Non-HDL-C is calculated as total cholesterol minus HDL-C

So, for practical purposes non-HDL-C levels are used for lipid management in secondary prevention of CVD using non-fasting blood samples.

However, in patients who don’t meet the NICE approved Lipid Management Guidelines target of a non-HDL-C below 2.5mmol/l for secondary prevention in CVD, injectable therapies are an option. Where injectables are being considered, it is important to know the LDL-C level, hence the need for a fasting blood sample to assess eligibility for these drugs.

It is also important to check and consider the triglyceride level because if this is above 4.5mmol/l on a fasting sample then the Friedewald formula to calculate LDL-C is not valid and these patients should be discussed with a lipidologist.

In summary, if the non-HDL-C remains above 2.5mmol/l in patients with CVD and injectable therapies are being considered, do a fasting lipid profile for LDL-C. Providing the triglycerides are below 4.5mmol/l, if the LDL-C is above 2.6mmol/l, Inclisiran can be offered, if it’s above 3.5mmol/l PCSK9i, drugs can be considered.

Understand and take practical steps to tackle FH

Go

NHS Long Term Plan

The NHS Long Term Plan, launched in 2019, sets out bold ambitions to tackle cardiovascular disease.

Key elements for lipids/CVD:

  • Prevent over 150,000 heart attacks and strokes within 10 years
  • Find 25% of people with familial hypercholesterolaemia (FH) within 5 years
  • Launch the CVD PREVENT national audit to support continuous clinical improvement

Download a summary of the plan

CVDPREVENT

CVDPREVENT is a national primary care audit that automatically extracts routinely-held GP data covering diagnosis and management of six high-risk conditions that cause stroke, heart attack and dementia:

Atrial fibrillation (AF), High Blood Pressure, High Cholesterol, Diabetes, Non-diabetic Hyperglycaemia, Chronic Kidney Disease.

Key principles and benefits

Helps to support the ambition laid out in the NHS Long Term Plan to prevent 150,000 heart attacks and strokes over the next 10 years.

The audit asserts zero additional burden on practices.

Data on health inequalities and gaps in care will be highlighted to help support improvements in local practice.

Visit the CVDPREVENT site.

The 2nd CVDPREVENT Annual Audit Report and Data and Improvement Tool has now been published. The CVDPREVENT audit, commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) and funded by NHS England & NHS Improvement, aims to support professionally-led quality improvement in primary care for the prevention of cardiovascular disease (CVD) in England. The audit is delivered by the NHS Benchmarking Network, the Office for Health Improvement & Disparities (OHID) - National Cardiovascular Intelligence Network (NCVIN) team, and NHS Digital.

CDRC

The Clinical Digital Resource Collaborative (CDRC) is an NHS-funded, digital resource that enables individuals and organisations to deliver gold-standard patient care efficiently.

Download the CRDC overview

 

Primary care key benefits:

Integrated digital resources for SystmOne and EMIS
Quick identification of patients who are likely to benefit from a change in clinical management
More accurate data for QOF and QASI reporting

Visit the CRDC website

Examples of best practice

For this section, we've pulled together some examples of best practice. If you'd like to share examples from your area, please get in touch.

West Yorkshire & Harrogate Healthy Hearts

Clinical system searches and treatment guidance

Example treatment options and process

Optimisation and initiation of statins

Visit the WYH site

Our cookies

We use cookies, which are small text files, to improve your experience on our website.
You can allow or reject non essential cookies or manage them individually.

Manage cookiesAllow all

Cookie policy

Our cookies

Allow all

We use cookies, which are small text files, to improve your experience on our website. You can allow all or manage them individually.

You can find out more on our cookie page at any time.

EssentialThese cookies are needed for essential functions such as logging in and making payments. Standard cookies can't be switched off and they don't store any of your information.
AnalyticsThese cookies help us collect information such as how many people are using our site or which pages are popular to help us improve customer experience. Switching off these cookies will reduce our ability to gather information to improve the experience.
FunctionalThese cookies are related to features that make your experience better. They enable basic functions such as social media sharing. Switching off these cookies will mean that areas of our website can't work properly.
AdvertisingThese cookies help us to learn what you're interested in so we can show you relevant adverts on other websites and track the effectiveness of our advertising.
PersonalisationThese cookies help us to learn what you're interested in so we can show you relevant content.

Save preferences