Medicating High Cholesterol

Sometimes positive changes in diet, lifestyle and exercise are not enough. In these cases, doctors may consider the use of medication that lowers cholesterol. The decision to have a patient begin medication is often based on high levels of LDL cholesterol and other risk factors for cardiovascular disease. For example, medication may be indicated if your LDL level is over 190 or is over 160 and you have several other risk factors for cardiovascular disease.

Drugs that reduce LDL blood levels can prevent or reduce the build-up of artery blocking plaques and can limit the possibility of the release of those plaques as dangerous blood clots. There are several types of drugs that can help reduce blood cholesterol levels. The most commonly prescribed are the statins, HMG-CoA reductase inhibitors, including:

• Lovastatin (Mevacor)
• Simvastatin (Zocor)
• Atorvastatin (Lipitor), a new, highly potent drug

These drugs work within the liver to directly prevent the formation of cholesterol and can lower LDL cholesterol by as much as 40 percent. Research also shows that these drugs can reduce the risk of death from cardiovascular disease. Another major drug category is the resins, which bind bile acids, causing the liver to produce more of them and using up cholesterol in the process. By "tying" it up, these drugs make cholesterol less available in the blood. They include:

• Cholestyramine (Questran)
• Colestipol (Colestid)

The B vitamin Niacin, in high doses, can lower triglycerides and LDL levels and increase HDL levels. Niacin has been proven to reduce a person's risk of having a second heart attack. Last are the drugs in the fibrates category, which lower triglycerides and can increase HDL levels. These include:

• Gemfibrozil (Lopid)
• Fenofibrate (Tricor)

The decision to take cholesterol- or lipid-lowering drugs is not taken lightly by your doctor. These drugs can be fairly expensive and are often required for many years or even the rest of your life. It is also important to note that some of these drugs can have dangerous side effects, such as damage to the liver.

Adopting a healthy lifestyle and visiting your doctor regularly can help curb your risks of problem cholesterol. Have your cholesterol levels checked by a physician, rather than risk incorrectly interpreting numbers in self test kits currently on the market. Remember, cholesterol is necessary for life but it can also be very harmful and requires monitoring. So, watch your cholesterol and keep in mind that, for every 1 percent drop in your cholesterol level, your risk of heart attack is lowered by 2 percent.

For more information on cholesterol and related topics, check out the links on the next page.