Lipid Optimisation Lipid Education and Management

This leaflet will provide you with information about your lipids and lipid treatment, otherwise known as lipid optimisation. It will give some background information on cholesterol to help your understanding and briefly explain why we use the treatments we do.

What are Lipids?

• When you hear the word lipids, you may think of a harmful substance which you want to totally remove from your body.
• In truth, lipids are necessary for several processes in your body, including helping you digest foods and keeping your teeth, bones and muscles healthy.
• Lipids are types of fats which are found in the blood. Most of them are made in your liver, but some comes from your diet.
• The type of lipids in your blood are cholesterol, triglycerides, HDL and LDL.

Good Lipids vs Bad Lipids

• High-Density Lipoprotein (HDL) is often called Good Lipids. These are ‘high density’ as they have lots of protein. They help prevent disease.

• You can get Good Lipids in your lifestyle, exercise and healthy diet.
• Low-Density Lipoprotein (LDLs) are the opposite, Bad Lipids. They carry lots of cholesterol, which is harmful to your heart and brain, when in excess because it can clog up the paths your blood needs to travel through.
• Triglyceride is a Bad Lipid is found in: high fat diet, smoking and drinking in excess.

It is also seen if you have poorly controlled diabetes, then you will have a high triglyceride, which can have deleterious effect on your heart and brain which can result in problems with heart and brain.

Consequences of too much Bad Lipids

• If there is too much Bad Lipids in your blood (particularly LDL), it will deposit on the walls of your arteries (the vessels which carry blood from your heart to your organs). If this goes on for a long time, a plaque will build up which stiffens the arteries and makes the gap that blood can travel through narrower, or block it entirely. This is called Atherosclerosis.
• Several issues can follow from atherosclerosis, including: Heart Attack, Stroke, Mini-Stroke, Coronary Heart Disease, Heart Failure and Vascular Dementia.
• Uncontrolled type 2 diabetes can also raise Triglycerides or Bad Lipids.
• To avoid these outcomes, there are many things you and your medical team can do to keep your levels of Bad Lipids under control.

Ways to Manage Your Lipids

1. Diet
   • Aim for a varied diet, which emphasises foods that are unprocessed, colourful, and wholegrain.
   • Try to limit the amount of unsaturated fats (i.e. butter, full fat dairy, fatty meats) and consume more unsaturated fats (i.e. nuts, seeds, avocados, olive oil).
2. Exercise
   • An active lifestyle can raise your levels of Good Lipids and lower your Bad Lipids.
   • Adults should aim for a minimum of 150 minutes (two and a half hours) of moderate activity (like walking, jogging or cycling) or 75 minutes of intense activity per week.
3. Stop Smoking
   • Smoking increases the harm that Bad Lipids can cause you. It makes the plaque stickier, making it more likely to clog your arteries. It also lowers your levels of Good Lipids.
   • Within one year of quitting smoking, your risk of heart disease will be cut in half.
   • The Smokefree National Helpline is there to help: 0300 123 1044.
4. Limit Alcohol Consumption
   • Your body processes alcohol by breaking it down and producing cholesterol. If too much damage is done to your liver, it will not be able to remove cholesterol from the blood as effectively.
   • It is recommended that you not consume more than 14 units of alcohol (which is six pints of lager, six 175mL glasses of wine or 14 shots of 40% spirit) per week. We advise against binge drinking and encourage alcohol free days within your week.

5. Lipid lowering drugs

• • Statins are often used as the first line treatment to lower Bad Lipids. They work by slowing down its production in the liver, allowing your body to remove it more effectively.
  • If statins aren’t as effective as we would like, there are other treatments which may work better for you. These include ezetimibe, bempedoic acid and lipid lowering injections such as PCSK9 inhibitors and inclisiran.

Appointment Blood Forms

• • As the lipid optimisation team, we will send out blood forms for relevant tests about a month before you are scheduled to attend an appointment.
  • We ask that if you have not received one of these forms three weeks prior to an appointment, that you contact the department using the following number (0151 706 2115) so that a form can be arranged for you.

Importance of Attending Appointments

• • In order to keep your cholesterol levels under control, it is extremely important that you engage with the service provided. This will allow your doctors and nurses to keep a close eye on your blood results and adjust your treatment accordingly.
  • If you do not engage with the service, you will be discharged in order to preserve resources for patients who require them. Below is the departmental policy.
  • If you are a new referral, there is an allowance for one DNA (Did Not Attend appointment) and two rearrangements for an appointment. If the patient exceeds this allowance, they will be discharged.
  • If the patient is under follow-up, there is an allowance for two DNAs and two rearrangements. If the patient exceeds this allowance, they will be discharged.

Feedback

Your feedback is important to us and helps us influence care in the future.

Following your discharge from hospital or attendance at your outpatient appointment you will receive a text asking if you would recommend our service to others. Please take the time to text back, you will not be charged for the text and can opt out at any point. Your co-operation is greatly appreciated.

Further information:

The Heart UK Website - https://www.heartuk.org.uk/cholesterol/overview British heart foundation - https://www.bhf.org.uk/

Fag ends - https://www.smokefreeliverpool.co.uk/