After your heart health check visit, you can take action to lower your chance of heart attack or stroke.
Take action for a healthy lifestyle
Action plan: Change your habits for a healthy lifestyle
Weigh up the pros and cons of heart medicine
Here you can find out more about the types of medicine prescribed to lower your risk of heart disease.
These decision aids can help you:
- understand your medicine choices
- weigh up the pros and cons, and
- consider what matters to you.
The pros and cons of taking medicine
Take cholesterol medicine
Explanation: Take medicine every day to lower your cholesterol.
Pros: Lowers your chance of a heart attack or stroke.
Cons: You may get side effects like muscle aches.
Take blood pressure medicine
Explanation: Take medicine every day to lower your blood pressure.
Pros: Lowers your chance of a heart attack or stroke.
Cons: You may get side effects like feeling dizzy or fainting.
How do you feel about taking medicine for your heart health?
How do you feel about these medicine choices? Here are some ideas from other people who were offered medicine to prevent heart disease. Do you agree or disagree with these statements?
- I always follow my doctor’s advice.
- I want to do everything I can to lower my heart disease risk.
- I don’t mind taking pills.
I don’t want to risk any side effects.
I prefer to lower risk through lifestyle first.
I don’t like taking pills.
More detailed information about medical choices
Australian guidelines recommend medicine to lower your blood pressure, if the risk calculator shows you are at high risk. It may also be recommended if you are moderate risk but have extra risk factors. This option involves taking a pill every day. The dose and type of medicine may change depending on how well your blood pressure is controlled, and any side effects. Common medicines used in Australia include:
• ACE Inhibitor
• Angiotensin receptor blocker
• Calcium channel blocker
• Low dose thiazide or thiazide-like diuretic
Take action:
Start blood pressure lowering medicine
Benefits:
You are less likely to have a cardiovascular event (e.g. heart attack or stroke) if you take blood pressure medicine, compared to a placebo (inactive) pill. This table shows the effect if you lower your blood pressure by 10 mmHg:
| Risk of a heart attack or stroke in the next 5 years (CVD event) | Risk of CVD event if you do not take medicine | Risk of CVD event if you take cholesterol medicine |
|---|---|---|
| High risk – 20% | 200 events per 1000 people (20%) | 170 events per 1000 people (17%) |
| Moderate risk – 8% | 80 events per 1000 people (8%) | 70 events per 1000 people (7%) |
Harms:
Some people may experience low blood pressure (hypotension), fainting and kidney problems. This is more likely if you aim for a lower blood pressure target. This table shows some examples at different targets:
| Condition | Target blood pressure: 140 mmHg | Target blood pressure: 120 mmHg |
|---|---|---|
| Low blood pressure (also called hypotension) | 14 per 1000 people (1%) | 23 per 1000 people (2%) |
| Fainting (also called syncope) | 17 per 1000 people (2%) | 23 per 1000 people (2%) |
| Kidney problems (acute kidney injury or renal failure) | 25 per 1000 people (3%) | 41 per 1000 people (4%) |
Do nothing:
Don’t take blood pressure lowering medicine
| Benefits | Harms |
|---|---|
| You will not be at risk of side effects from the medicine. | Your risk of a heart attack or stroke will be higher than it could be. |
| You will not have to pay for the medicine. | Your risk will increase as you age, if no other actions are taken. |
References:
2023 Australian guidelines available at https://www.cvdcheck.org.au/
Blood Pressure Lowering Treatment Trialists’ Collaboration. Blood pressure‐lowering treatment based on cardiovascular risk: a meta‐analysis of individual patient data. The Lancet. 2014 Aug 22;384(9943):591‐8.
Australian guidelines recommend cholesterol-lowering medicine for those at high risk. It may also be recommended for moderate risk if you have extra risk factors or if lifestyle change is not effective after 3-6 months. This involves taking a pill every day, for as long as you and your doctor agree that the benefits outweigh the harms. The dose and type of medicine may need to be adjusted depending on how well you tolerate the initial pill, and what effect this has on your LDL (low-density lipoprotein) cholesterol (the “bad” cholesterol). The common type is called statin.
Take action:
Start cholesterol lowering medicine
Benefits:
You are less likely to have a cardiovascular event (e.g. heart attack or stroke) if you take cholesterol medicine, compared to a placebo (inactive) pill. This table shows the effect if you lower your cholesterol by 1 mmol/L:
| Risk of a heart attack or stroke in the next 5 years (CVD event) | Risk of CVD event if you do not take medicine | Risk of CVD event if you take cholesterol medicine |
|---|---|---|
| High risk – 20% | 200 events per 1000 people (20%) | 150 events per 1000 people (15%) |
| Moderate risk – 8% | 80 events per 1000 people (8%) | 60 events per 1000 people (6%) |
Harms:
Some people report side effects from taking cholesterol medicine. This can include muscle aches, arthritis, nausea, constipation and diarrhoea. But the chance of this is about the same for people taking cholesterol medicine, compared to a placebo (inactive) pill. You may need a blood test to check your liver and kidney function. Some research has found a small increase in diabetes, shown in this table:
| Condition | Chance for people taking a placebo (inactive) pill | Chance for people taking cholesterol medicine |
|---|---|---|
| Diabetes | 24 people with diabetes per 1000 people (2%) | 28 people with diabetes per 1000 people (3%) |
Do nothing:
Don’t take cholesterol lowering medicine
| Benefits | Harms |
|---|---|
| You will not be at risk of side effects from the medicine. | Your risk of a heart attack or stroke will be higher than it could be. |
| You will not have to pay for the medicine. | Your risk will increase as you age, if no other actions are taken. |
References:
2023 Australian guidelines available at https://www.cvdcheck.org.au/
Taylor F, Huffman MD, Macedo AF, Moore TH, Burke M, Davey Smith G, Ward K, Ebrahim S. Statins for the primary prevention of cardiovascular disease. The Cochrane Library. 2013 Jan 1.