492. Cholesterol-Lowering Medication

High Cholesterol: Cholesterol-Lowering Medication

Sometimes cholesterol medication is recommended in addition to a low-saturated fat, low-refined carbohydrate, and high-fiber diet to lower cholesterol.

Cholesterol is an important part of your cells and also serves as the building block of some hormones. The liver makes all the cholesterol the body needs. But cholesterol also enters your body from dietary sources, such as animal-based foods like milk, eggs, and meat. Too much cholesterol in your blood can increase the risk of coronary artery disease.

Recommended Related to Cholesterol Management

        Your health care provider may send you for cholesterol tests, either as a part of a standard check-up or because he or she suspects you may be at risk for developing heart disease. But do you know what the cholesterol test results actually mean? Read on to learn how to interpret the numbers.

        The first line of treatment for abnormal cholesterol is usually to eat a diet low in saturated and trans fats, and high in fruits and vegetables, nuts, and seeds, and to increase exercise. But for some, these changes alone are not enough to lower blood cholesterol levels. These people may need medicine, in addition to making lifestyle changes, to bring their cholesterol down to a safe level.

Cholesterol-lowering drugs include:

·Statins

·Niacin

·Bile-acid resins

·Fibric acid derivatives

·Cholesterol absorption inhibitors

Continue reading below...

Cholesterol-lowering medicine is most effective when combined with a healthy diet and exercise.

How Do Statins Work?

        Statins block the production of cholesterol in the liver itself. They lower LDL, the "bad" cholesterol, and triglycerides, and have a mild effect in raising HDL, the "good" cholesterol. These drugs are the first line of treatment for most people with high cholesterol. Statins have been shown in multiple research studies to reduce the risk of cardiovascular events like heart attacks and death from heart disease.

Side effects can include

1.      intestinal problems,

2.      liver damage, and in a few people,

3.      muscle tenderness.  

        Statins also carry warnings that memory loss, mental confusion, high blood sugar, and type 2 diabetes are possible side effects.

        It's important to remember that statins may also interact with other medications you take. 

Examples of statins include:

1.      Atorvastatin         (Lipitor)

2.      Fluvastatin           (Lescol)

3.      Lovastatin            (Mevacor)

4.      Pravastatin           (Pravachol)

5.      Simvastatin          (Zocor)

6.      Rosuvastatin        (Crestor)

How Does Nicotinic Acid Work?

        Nicotinic acid is a B-complex vitamin. It's found in food, but is also available at high doses by prescription.

        It lowers LDL cholesterol and raises HDL cholesterol.

        The main side effects are flushing, itching, tingling and headache. 

        A recent research study suggested that adding nicotinic acid to statin therapy was not associated with a lower risk of heart disease. Examples of nicotinic acid medication include:

·Nicolar and

·Niaspan

How Do Bile Acid Resins Work?

These drugs work inside the intestine, where they bind to bile from the liver and prevent it from being reabsorbed into the circulatory system. Bile is made largely from cholesterol, so these drugs work by depleting the body's supply of cholesterol. The most common side effects are constipation, gas and upset stomach. Examples of bile acid resins include:

·Questran and Questran Light

·Colestid

·WelChol

How Do Fibrates Work?

Fibrates reduce the production of triglycerides and can increase HDL cholesterol. Examples of fibrates include:

·Atromid

·Tricor

·Lopid

Ezetimibe (Zetia) lowers bad LDL cholesterol by blocking cholesterol absorption in the intestine. Research studies have not found that ezetimibe is associated with a lower risk of heart disease.

Related to Cholesterol & Triglycerides

·Atherosclerosis

·Diabetes

·Diet & Nutrition

·Drug Interaction Checker

·Heart Disease

·High Blood Pressure

·High Triglycerides

·Living Healthy

·Metabolic Syndrome

·Stroke

What is your LDL (low-density lipoprotein) level?

Less than 100 mg/dl

100 to 129 mg/dl

130 to 159 mg/dl

160 to 189 mg/dl

Higher than 190 mg/dl

Answer:

Desirable         0-199

Borderline       200-239

High                240+

Your level is currently
Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.
Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

491. Cholesterol - High cholesterol

High cholesterol

        Cholesterol is a type of fat (lipid) made by your body.
        It's essential for good health and is found in every cell in your body.
        However, having a high level of certain types of cholesterol in your blood (hypercholesterolaemia) can increase your risk of cardiovascular disease, such as heart disease and stroke.

What cholesterol is and what blood tests for high cholesterol show

About high cholesterol

        If you have high cholesterol, it may affect your heart and blood vessels and increase your risk of developing cardiovascular disease.
        High cholesterol causes fatty deposits (known as plaques) to build up inside your blood vessels.
        In time, the blood vessels supplying your heart may become so narrow.
        They can't deliver enough oxygen to your heart muscle, particularly when you're exerting yourself.
        This can cause you to feel chest pain (angina).
        If a fatty plaque breaks off, it may cause a blood clot that can block blood flow to your heart (heart attack), or if the same process occurs in your brain it may cause a stroke.

Types of cholesterol

        Cholesterol is transported around your body attached to a protein in your blood.
        This combination of fat and protein is called a lipoprotein.
        There are different types of lipoprotein, depending on how much fat there is in relation to protein.

HDL

        A small amount of your body’s cholesterol is transported as high-density lipoprotein (HDL), which is mostly protein and not much fat.
        HDL transports excess cholesterol from your tissues (including the walls of arteries) to your liver for disposal.
        As HDL helps prevent cholesterol building up in your blood vessels, you have a reduced risk of heart disease if you have high levels of this type. This is why HDL is often referred to as ‘good’ cholesterol.

LDL

        Most of your body's cholesterol is transported as low-density lipoprotein (LDL). It consists mainly of fat, with not much protein.
        LDL transports cholesterol from your liver to your cells.
        High levels of LDL increase your risk of cardiovascular disease because LDL causes cholesterol to build up in your blood vessels.
        LDL is often called ‘bad’ cholesterol.

Triglycerides

        Triglycerides are another type of lipid that mostly come from fats in your food.
        Energy from your food that isn’t used immediately is converted into triglycerides and transported to fat cells for storage.
        This provides you with an important source of stored energy.
        Although most triglycerides are stored as fat, low levels are also found in your blood.
        Having a raised level of blood triglycerides together with high LDL can increase your risk of heart disease, particularly if you have diabetes, high blood pressure or you smoke.

Total cholesterol

        If you have a high total cholesterol level, this is a risk factor for future health problems, such as cardiovascular disease. But the ratio of how much HDL you have compared to total cholesterol is important too. This is called your total cholesterol (TC) to HDL cholesterol ratio (TC:HDL). You should aim for a high level of HDL cholesterol and a low level of LDL (a low TC to HDL ratio).

Symptoms of high cholesterol

        You may only find out that you have high cholesterol if you have a cholesterol test as part of a health check up, or if you develop symptoms of heart disease. Sometimes, yellow patches (called xanthomas) may develop around your eyes or elsewhere on your skin – these are cholesterol deposits and may show that you have high cholesterol.

Complications of high cholesterol

        If you have high cholesterol, it increases your risk of heart disease and stroke.
        It may also affect arteries elsewhere in your body such as your legs – this is known as peripheral arterial disease.

Causes of high cholesterol

There are several factors that may contribute to you having high cholesterol.
These include:

·having a diet high in saturated fat

·a lack of exercise

·being obese (having a body mass index (BMI) of 30 or more)

·drinking more than the recommended daily amount of alcohol (this increases the level of triglycerides in your blood)

·smoking

·age and gender – your cholesterol levels generally rise with increasing age and can be affected by your gender

        If you're a man younger than 55 you're more likely to have high cholesterol than a woman.
        If you’re a woman over 55 and past the menopause, your cholesterol levels are likely to increase.
        High cholesterol can sometimes be caused by a condition that runs in your family called familial hypercholesterolaemia (FH).
        In the UK, about one in 500 people have this condition. It’s not caused by an unhealthy lifestyle but is passed through families by a faulty gene.

Other conditions, such as

1.    poorly controlled diabetes,

2.    certain kidney and

3.    liver diseases and

4.    underactive thyroid (hypothyroidism)

may also cause your levels of cholesterol or triglycerides to be high.
        Some medicines such as the oral contraceptive pill, beta-blockers, steroids or thiazides (a type of diuretic) may also affect your blood lipid levels.

Diagnosis of high cholesterol

        Your cholesterol level is measured with a blood test. Usually you will be asked not to eat for 12 hours before the test so that your food is completely digested and doesn't affect the result. Your doctor or nurse may take a blood sample using either a needle and syringe, or a finger prick. You can have your cholesterol tested at your doctor’s surgery, at hospital, or as part of a health assessment examination.
        Home-testing kits for cholesterol are also available but may not be very accurate. Speak to your pharmacist about your result if you use a kit.
        There is no recommended target level of cholesterol, unless you already have cardiovascular disease or are at high risk.
        In these instances, your cholesterol levels should ideally be:

·under 4mmol/l for total cholesterol

·under 2mmol/l for LDL cholesterol

·above 1mmol/l for HDL cholesterol

·under 1.7mmol/l for triglycerides

        The levels of cholesterol in your blood can vary from day to day, so your doctor may take a series of different readings before recommending any treatment.

Who should have a cholesterol test?

        If you’re at high risk of cardiovascular disease or you have a family history of high cholesterol, you should have your cholesterol levels checked.
        Speak to your doctor about how often it should be tested.
        Your doctor should check your cholesterol levels every year if you have cardiovascular disease.

Treatment of high cholesterol

If you have high cholesterol, there are two ways in which you can reduce it.
        The first is with lifestyle changes, which include

1.    changing your diet,

2.    managing your weight and

3.    exercising.

        The second is to combine lifestyle changes with cholesterol-lowering medicines.

Self-help

        By eating healthily, you can reduce your cholesterol levels. Your diet should be low in saturated fats in particular, and low in fat overall. Biscuits, cakes, pastries, red meat, hard cheese and butter all tend to be high in saturated fats, so it’s good to cut down on these foods.
        Some foods such as eggs, prawns and offal (for example, liver and kidneys) contain cholesterol.
        This type of cholesterol is known as dietary cholesterol and it has a much lower effect on blood cholesterol than saturated fat in your diet. You may need to cut down on these foods if your doctor advises you to.
        It's also important to include plenty of fibre in your diet, especially soluble fibre, which helps to lower cholesterol.
        There is soluble fibre in fruits and vegetables, beans and oats.
        Aim to eat at least five portions of fruit and vegetables each day.
        Eating foods containing substances called plant sterols or stanols, contained in some yoghurts or spreads, may help to lower high cholesterol, but they are not a substitute for a healthy diet.
        If you're overweight, losing your excess weight can reduce your LDL levels and increase your HDL levels.
        Increasing your physical activity may enhance the cholesterol-lowering effects of your diet.
        As high cholesterol can increase your risk of heart disease, you should reduce any additional risk of developing it, such as by stopping smoking.

Medicines

        Medicines are generally recommended either if you already have cardiovascular disease or if your risk of getting it is more than 20 percent over 10 years.
        The main group of medicines for lowering cholesterol are called statins.
        Statins available in the UK include

1.    simvastatin,

2.    atorvastatin,

3.    fluvastatin,

4.    pravastatin, and

5.    rosuvastatin.

        These medicines work by reducing the production of cholesterol in your liver, but can have side-effects such as indigestion and muscle pains.
        Other types of medicines used to reduce cholesterol include

1.    fibrates,

2.    nicotinic acid and

3.    cholesterol-absorption

4.    inhibitors such as ezetimibe (Ezetrol),

but these are generally less effective than statins or have more side-effects. If you have very high cholesterol, your GP may prescribe ezetimibe with statins.

Prevention of high cholesterol

        You may be able to prevent high cholesterol by keeping to a healthy weight and eating a diet that is low in saturated fat.
        Try to include at least two portions of fish per week in your diet, of which at least one should be an oily fish such as mackerel or salmon.
        Try to take regular exercise, avoid smoking and stick to recommended limits of alcohol.
        If you don’t have high cholesterol, consuming products containing plant sterols or stanols, such as yogurts or spreads, is not recommended (and they are not suitable for women who are pregnant or breastfeeding).