Serum Cholesterol levels

Depends on the individual levels of LDL, HDL, VLDL and Triglycerides (which would be the concerning one). You can also work out the HDL/Triglycerides ratio which will tell you how likely you are to have a stroke/heart attack.

Sounds very high to me.

I have zero medical knowledge, but that's not going to stop me opining NICE thresholds are too high. I understand public health is complex but personally I think if you have other risk factors like family history then you should reduce the cited healthy thresholds above by 20% at least.

Even if you consider the CVD lipid evidence to be patchy, it seems likely to me that if your TC is above 5, then your health will benefit from exercise and diet improvements to try and get your numbers down.

Non HDL is the number I'd be tracking. I’d be unhappy with Non HDL above 3 if you have any risk factors.

Exercise and weight loss is best but I’d push for statins if these don’t achieve good results. You might need to tell GP that you have tried lifestyle, or you have other risk factors. But they should def prescribe statins at these levels if lifestyle doesn't achieve swift results. (3-6 months is long enough to show results)

If you are serious I would invest £90 in 3x non HDL test every two months from monitormyhealth website (uses NHS Labs) and keep logs of your exercise and weight loss, then see GP again in 6 months with the results. They don't like private tests, but if you stick to tests that align with GP guidelines and show you have taken exercise seriously, then they will be more inclined to escalate

Also, Dr Sten Ekberg has something on Statins and side effects here:

https://www.youtube.com/watch?v=tJn5EE3fMDs&ab...

And Dr. Cywes on dangers and side effects here:

https://www.youtube.com/watch?v=54pRQG79nU0&ab...

Due to family issues, and subsequent testing, I was diagnosed with familial hypercholesterolemia 30 years ago, in my early 20's in otherwose prime health

I've been on and off treatment since then. Off treatment my levels go to mid teens, on a statin within guidelines. I've never had any problems on them, the condition comes courtesy of my mother's bloodline. She's now in her early 80's, which is over 25 years more than her father made. Whether there's correlation who knows, but it seems likely.

Whether they are a magic bullet or preventative for the masses, who knows?

There is little doubt that statins are effective in lowering blood cholesterol levels. And there is evidence that statin use lowers the rate of death from heart attacks and strokes by 0.4%. it's is not clear what the mechanism is, possibly, it's an anti-oxidant effect.

However, statin use also increases the risk of death from other causes including cancer by 0.3%

0.1% more death might add up to a lot of bodies.

Personally, I'll accept the net +0.1% statistical death risk, avoid taking these poison pills forever, and do my best to mitigate my mortality with healthy choices: More exercise, much less caffeine, & try to avoid sugar & carbs (except for treats). I've even lowered my booze intake a bit.

Will I live forever? Who knows, but so far so good!

I believe you are comparing an absolute risk number. To a relative risk number? The relative reduction in cardiac events is more like 25%-50% I am told. Depending on your health of course

For ‘a healthy person’ it’s true there is less benefit and doctors should act accordingly. however I would guess a scary high number of people over 50 have some degree of heart disease and are not nearly as healthy as they think.

Personally I asked my gp twice for statins on the advice of a cardiac nurse relative who knew my family history, and is at the coal face every day. I was refused both times and advised excercises is better option at my age. Later, an angiogram would prove a clear benefit of statins in my case. Nurses are underrated!

Also I had initial side effects and doctor advised stopping the statin or reducing the dose until they had clarified the root cause. So I don’t think doctors are on a profit hunt, in my experience. We compromised on a low 5mg dose which was equally effective in ldl terms and zero side effects.

Yes that’s how genetic risk works. It’s independent of lifestyle for most part.

And why the calculator doesn’t ask you if any of your mates with have had a heart attack. (Though the postcode box does that I guess)

I suspect the Risk Calculator postcode is used to assign a deprivation factor .

So to cheat death, simply move house!

Edit to fix link

I’ve not heard of Ezetimbe before but I see it’s another weapon in the war on cholesterol. That’s the whole premise that many reputable doctors and scientists question challenge! (At least those that have read the early Framingham trial papers etc past the abstract.)

Cholesterol is made in our amazing livers, is vital to every part of the body, our brains more than most. I want my liver to function normally and not be poisoned by some nasty pharmaceutical concoction based on bad science.

Not so!
And whilst most busy GPs might try to opt for a quiet life, if you look at the link I posted above, you will see some very prominent doctors:

Leading Doctors Reject Latest Statin Guidance From The National Institute for Health and Care
Excellence
An open letter has been sent to the chair of NICE and the secretary of state for health, Jeremy Hunt,
from leading doctors in primary care, secondary care and academia. They reject the recent draft
guidance from NICE to reduce the threshold for prescribing statins to those with a 10% risk of
cardiovascular disease (potentially treating an additional five million healthy individuals).
The letter is signed by a number of leading figures in health including the president of the Royal
College of Physicians, Sir Richard Thompson, Professor Clare Gerada, Past Chair of the Royal College of
General Practitioners and Professor Simon Capewell, Clinical Epidemiologist at the University of
Liverpool.
Other signatories include Professor David Haslam, Chair Of The National Obesity Forum, GP Dr
Malcolm Kendrick, London Cardiologist Dr Aseem Malhotra and Professor David Newman, Emergency
Medicine physician and Director of clinical research and Mount Sinai School of Medicine, New York.

They address six major concerns and call on NICE to refrain from any final recommendations on
reducing the threshold for statin guidance until these are fully addressed.
These six key areas are:
1. The medicalization of millions of healthy individuals
2. Conflicting levels of adverse events
3. Hidden data
4. Industry bias
5. Loss of professional