You've followed your doctor's advice and changed your habits. You're watching what you eat and getting more exercise. Still, your cholesterol is high. What can you do?
Some people may also need medications to help lower their cholesterol. Medicines are usually reserved for people who haven't been able to lower their cholesterol or triglyceride (blood fat) levels through diet and lifestyle changes, or who are at high risk for heart disease. These medicines help lower the risk of a heart attack or stroke.
What is cholesterol?
Cholesterol is a waxy, fat-like substance found in the cells of the body. The liver makes the cholesterol that the body needs. But cholesterol in foods we eat provides more than we need. Extra cholesterol travels in the blood. It can build up in the arteries. This buildup is called plaque. It can narrow or block the arteries. That can reduce or stop the flow of blood. When plaque blocks arteries in the heart, chest pain and heart attack can result.
There are two kinds of cholesterol. They are high-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL is known as "good" cholesterol. LDL is known as "bad" cholesterol.
Your cholesterol level can affect your chances of getting heart disease. High cholesterol is a major risk factor for heart disease, heart attack and stroke. Heart disease kills more adults every year than any other disease.
Medicines that lower cholesterol
Several types of drugs can lower bad cholesterol levels. Each works differently. Your doctor will determine if one of them is right for you. Side effects are generally mild and go away as your body adjusts. Even if your cholesterol levels drop, you will probably be advised to continue taking them. These medications are usually safe for as long as you need them.
Here is more information on the types of drugs that lower cholesterol. Be sure to ask your doctor for the monitoring schedule that is right for you and the side effects that you should report.
Statins block the liver from making cholesterol. Statins have been most successful at lowering bad cholesterol. They also can moderately lower fats in the blood and increase good cholesterol. Statins are safe for most people.
Side effects are mild. They usually go away as your body adjusts. It is rare for a statin to cause muscle or liver problems. If you are at risk for these, you may get regular liver function tests. Pregnant women or people with liver disease should not take statins.
Some statin users have reported brain-related problems such as memory loss, forgetfulness and confusion. In general, the symptoms were not serious and were reversible after the patient stopped taking the statin. However, you should not stop taking your medication on your own. Always talk to your doctor first.
People who take statins may be at more risk for developing high blood sugar levels and type 2 diabetes. Your doctor may need to assess your blood sugar levels after you begin taking statins.
Some medications interact with the statin lovastatin that raises the risk of myopathy. This type of muscle damage is characterized by unexplained weakness and pain. As they break down, these medications follow the same route in the body as the statin. The FDA is updating its labeling for lovastatin to clarify the risks and spell out the drugs that should not be taken at the same time.
Selective cholesterol absorption inhibitors
These medicines keep the intestine from absorbing cholesterol. They lower the bad cholesterol. They can modestly lower blood fats and raise good cholesterol.
Resins or bile acid-binding drugs
Cholesterol is used to make bile. Bile is an acid needed for digestion. Resins stick to bile, so it can't help with digestion. The liver then makes more bile, using more cholesterol. That lowers the amount of cholesterol in the system.
In some people, these medications raise their level of blood fats.
Fibrates are used to lower triglycerides, which may raise the risk of coronary heart disease especially in women. Fibrates can also raise good cholesterol levels. They are not effective in lowering bad cholesterol. The may be recommend with a statin.
Niacin blocks the production of blood fats. It can raise good cholesterol, and can lower bad cholesterol and blood fats. To lower cholesterol, only use the medication prescribed by your doctor. Niacin available over the counter is not made for this use.
Niacin can cause side effects such as upset stomach, flushing and itching. Niacin can also cause liver toxicity.
Lifestyle still counts
Medications are an important tool for many who want to lower their cholesterol. But drugs can't do the work alone. Your ongoing good health also requires a balanced, healthy diet (watch those fats!) and an exercise routine right for you.
Note: If you are physically inactive or you have a health condition such as arthritis, diabetes, heart disease, pregnancy or other symptoms, check with your doctor before starting an exercise program or increasing your activity level. He or she can tell you what types and amounts of activities are safe and suitable for you.
Created on 10/08/1999
Updated on 09/10/2013
- National Heart, Lung, and Blood Institute. What is cholesterol?
- United States Food and Drug Administration. Cholesterol from you.
- United States Food and Drug Administration. FDA expands advice on statin risks.