Treatment and Prevention
Lowering cholesterol levels with treatment reduces the risk of developing coronary artery disease, heart attack, stroke, and other disorders.
A healthy lifestyle is the best defense against high cholesterol. This also helps against other risk factors linked to coronary artery disease. The following lifestyle changes are good first steps in treating high cholesterol:
- Follow a diet low in saturated fats and cholesterol.
- Eat a wide variety of vegetables, whole grains, fruits, nuts, and seeds.
- Boost your level of physical activity.
- Maintain a healthy body weight.
- Limit your alcohol consumption (no more than 2 drinks per day to a maximum of 9 per week for women or 14 per week for men).
If you quit smoking and keep your blood pressure down, it will help lower your risk of developing angina, heart attack, and stroke.
For people who are at a very high risk for coronary artery disease, drug therapy is started immediately along with lifestyle changes. For those at moderate or low risk for coronary artery disease, lifestyle changes are started, and medication therapy may be used if cholesterol target levels are not reached.
Medications used to treat high cholesterol include the "statins" (e.g., atorvastatin*, lovastatin, simvastatin), resins (e.g., cholestyramine, colestipol), fibrates (e.g., fenofibrate, gemfibrozil), cholesterol absorption inhibitors (e.g., ezetimibe), and niacin. Medications have been shown to lower the chance of further clogging of the arteries and treat cholesterol problems by lowering levels of LDL (bad) cholesterol or raising the levels of HDL (good) cholesterol.
Some people think that it's too late to change your habits if you've already had a heart attack, but this is not true. It's vital to reduce your cholesterol to help prevent a second heart attack. Some patients with heart disease are now treated with a "statin" even if their cholesterol is normal. Your body is constantly producing cholesterol, so you must take your medication and follow lifestyle changes as recommended by your doctor to prevent levels from rising.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
Glenn Gandelman, MD, MPH, FACC Assistant Clinical Professor of Medicine at New York Medical College, and in private practice specializing in cardiovascular disease in Greenwich, CT. Review provided by VeriMed Healthcare Network.