Best Statin To Lower Triglycerides

Alternatives To Statins For Lowering Cholesterol

Your best treatment option for high cholesterol depends on many factors.

Before your doctor recommends a prescription medication, they will look at several things, such as:

• your family medical history
• your risk for heart disease

Many doctors prefer to start with changes to diet and exercise. If those changes dont have enough effect, you might start taking medication to help the process along.

Statins are one commonly prescribed medication for controlling cholesterol, but these drugs might not be right for everyone. There are several treatment options for high cholesterol, including other medications and lifestyle changes.

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Good Cholesterol Vs Bad Cholesterol

When your doctor checks your cholesterol with a blood test called a lipid panel, the results arent simply one number. A full picture of your cholesterol level and whether or not it needs lowering comes from four separate but related values: LDL, HDL, triglycerides, and total blood cholesterol.

LDL, often referred to as bad cholesterol, stands for low-density lipoprotein. LDL transports cholesterol through your bloodstream to your cells. The bad part of LDL is that in high levels, it tends to build up fatty plaques inside your arteries a condition called atherosclerosis. Atherosclerosis reduces blood flow through the affected arteries, leading to an increased risk of heart and kidney disease, peripheral artery disease, stroke, heart attack, and blood clots. For adults, a healthy LDL level is less than 100 mg/dl.

HDL, or high-density lipoprotein, is often referred to as good cholesterol. It helps remove LDL from your bloodstream by carrying it back to the liver, where its broken down for excretion. Thus, HDL helps protect your heart from disease and lowers your risk of stroke. A healthy HDL level for adults is more than 60 mg/dl.

Triglycerides

Triglycerides are a type of fat that stores excess energy from the calories you consume. A high level of triglycerides indicates an increased risk of stroke and heart disease. A triglyceride blood test result above 150 mg/dl is considered too high.

Total blood cholesterol

How To Limit Sugar In Your Diet

A sugary diet can spell trouble, not only for your cholesterol levels, but also your overall health. Limiting added sugars will help cut down on empty calories and can also help you maintain a healthy weight, which is good for heart health.

While your body doesnât need sugars to work well, eating small amounts wonât harm your health. Women should limit themselves to 6 teaspoons per day. Men should shoot for 9 teaspoons each day.

If youâre looking to cut down on sugar in your diet, you can:

• Limit foods with added sugars like candy, cakes, or cookies.
• Cut back on sweetened soft drinks and sodas.
• Avoid refined carbs like white bread and pasta.
• Drink fewer alcoholic beverages.
• Swap sugary breakfast cereals or bars for whole foods like fruits, oatmeal, and yogurt.
• Check food labels for total added sugars.
• Choose foods that are low on the glycemic index, which help keep your blood sugar level stable. This includes fruits, vegetables, and whole grains.

Regular exercise can also help burn any extra calories you take through a sugary diet.

If youâre looking to cut back on sugar and youâre not sure how to get started, ask your doctor or a nutritionist for help.

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How To Cope With Side Effects

What to do about:

• stomach pain try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Puttinga heat pad or covered hot water bottle on your stomach may also help. If youre in a lot of pain, speak to a pharmacist or doctor.
• diarrhoea drink lots of fluids, such as water or squash, to avoid dehydration. Speak to a pharmacist if you have signs of dehydration such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor. Speak to a doctor if diarrhoea lasts for more than a week after you start ezetimibe.
• farting try to not eat foodsthat cause wind . Eat smaller meals, eat and drink slowly, andexercise regularly. There are pharmacy medicines that may also help, such as charcoal tablets or simeticone. Peppermint tea may also help.
• feeling tired try to relax when possible and avoid intense exercise to see if that helps. If these symptoms do not go away after 1 to 2 weeks, ask a pharmacist or doctor for advice.

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How Do I Measure My Triglyceride Levels

Triglycerides are fatty substances that are stored in fat cells. They are used to storing energy from food and serve as a reserve of energy. The body uses them when needed, such as during exercise or fasting.

The measurement of blood triglycerides is done using a test called a Lipid Panel Test. A lipid panel test includes cholesterol, HDL , LDL and triglycerides. It is usually ordered along with other lab work to see if there are any problems with your diet, weight, or health.

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Mechanism Accounting For The Lomitapide Induced Lipid Effects

Lomitapide is a selective inhibitor of microsomal triglyceride transfer protein . MTP is located in the endoplasmic reticulum of hepatocytes and enterocytes where it plays a key role in transferring triglycerides onto newly synthesized apolipoprotein B leading to the formation of VLDL and chylomicrons . Loss of function mutations in both alleles of MTP results in abetalipoproteinemia, which is characterized by the virtual absence of apolipoprotein B, VLDL, chylomicrons, and LDL in the plasma due to the failure of the liver and intestine to produce VLDL and chylomicrons . Lomitapide by inhibiting MTP activity reduces the secretion of chylomicrons by the intestine and VLDL by the liver leading to a decrease in LDL, apolipoprotein B, triglycerides, non-HDL-C, and Lp .

Medications For High Triglycerides

Many people who have high cholesterol also have high triglycerides . Some medications can help lower this type of fat directly. Once these levels go down, the total amount of cholesterol is often lowered.

A common prescription for high triglycerides is niacin or vitamin B-3. Niacin can help lower bad cholesterol and increase good cholesterol .

This is a good option for people who dont respond well to other medications because the side effects of niacin are mild. People taking this medication might experience the following:

• flushing of the face

When more aggressive treatment is necessary to treat high triglycerides, a class of medications called fibrates is often prescribed.

Also, dietary supplements of omega-3 fatty acids found in fish oil have been shown to reduce triglyceride levels.

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How To Lower Triglycerides Fast Without Medications

Unlike many illnesses, much of the treatment centered around how to lower triglycerides actually has a lot to do with lifestyle factors like diet and physical activity. In fact, moderate to slightly high levels of triglycerides may be managed in this way alone, without the use of prescription medications. Since what raises triglycerides in the first place is often the foods that we eat, it is not a wonder that a mere change in ingestibles can provide long term benefits in the form of lower triglycerides levels. And, the long term management of the amounts of these fats circulating in the blood can often be well managed with a diet to lower triglycerides combined with an increase in moderate exercise.

Fats are also best left alone as much as possible for anyone trying to stave off ever rising levels of the manufactured blood fats. As such, fried foods and those that contain trans fat or saturated fat should be eliminated from diets entirely. Not only does this decrease the likelihood that triglycerides will remain on the rise, a low fat diet also contributes to a reduced risk of obesity. Being overweight or obese is a major contributing factor to the increase of triglycerides in the blood, and adhering to a low fat diet can reduce this risk dramatically.

References:

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What Are Normal Cholesterol Numbers

Everyone aged 20 years and older should have his or her cholesterol levels checked at least once every 5 years. The blood test should be taken after fasting for 9 to 12 hours.

You should aim for a total cholesterol level of < 200 mg/dL. Levels of 240 mg/dL or above are considered high. For LDL, lower levels are better, and the goal should be below 130 mg/dL, with < 100 mg/dL being optimal. For HDL, higher numbers are better. An HDL level < 40 mg/dL is a major risk factor for developing heart disease. You want to aim for levels of 60 mg/dL or better to help lower this risk.

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How Do Foods Affect Triglyceride Levels

Eating foods high in simple sugars significantly contributes to high triglyceride levels. Follow these guidelines to limit simple sugars in your diet:

• Substitute beverages like colas, fruit drinks, iced tea, lemonade, Hi-C and Kool-Aid with artificially sweetened beverages labeled sugar-free or diet.
• Limit hard candies, chocolates, candy bars, and gummy bears.
• Avoid adding table sugar and brown sugar to cereal, drinks or foods. Instead, use an artificial or herbal sweetener or nothing at all!
• Choose sugar-free gum or mints instead of the regular versions.
• Try light or low-sugar syrups on pancakes and waffles.
• Spread breads and crackers with no-sugar-added jelly or preserves.
• Snack on whole fruit instead of fruit roll-ups and other fruit-flavored treats.
• When selecting cereals, choose those with no more than 8 grams of sugar per serving.
• Try sugar-free gelatin, popsicles, yogurts, and puddings instead of the regular versions.
• Be aware that desserts labeled fat-free usually contain more sugar than the full-fat varieties and the same number of calories.
• Cut back on or avoid eating sweets and dessert foods, including cookies, cakes, pastries, pies, ice cream, frozen yogurt, sherbet, gelato, and flavored ices. All of these foods contain high levels of sugar.
• Read the ingredients list on food labels, and limit foods that list any of the following words in the first few ingredients:

Hypertriglyceridemia Management According To The 2018 Aha/acc Guideline

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The 2018 AHA/ACC Guideline on the Management of Blood Cholesterol was a welcome update from the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults.1 Our new guideline reinforces the importance of a heart-healthy lifestyle, the use of statins as the first line agent in primary and secondary cardiovascular prevention and the importance of risk stratification to identify those who benefit most from these measures. Also of note, our new guideline features a specific section on hypertriglyceridemia. This section is composed of one class I and three class IIa recommendations followed by a synopsis and supportive text to assist clinicians in recognising and treating patients with hypertriglyceridemia.

Identify and Address Secondary Factors

The class I recommendation first identifies a population 20 years of age or older who have moderate hypertriglyceridemia defined as fasting or nonfasting triglycerides 175-499 mg/dL and advises searching for and treating secondary factors . The remaining three recommendations build on this.

Table 1: Secondary Factors

L-asparaginase

Use of Statin Therapy in Moderate Hypertriglyceridemia

Use of Statin Therapy in Severe Hypertriglyceridemia

The third recommendation endorses the initiation of statins in those with severe hypertriglyceridemia with ASCVD equal to or greater than 7.5% in concert with addressing secondary factors.

Other Therapies in Severe Hypertriglyceridemia

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Effect Of Pcsk9 Inhibitors On Clinical Outcomes

FOURIER TRIAL

It should be noted that that the duration of the FOURIER trial was very short and it is well recognized from previous statin trials that the beneficial effects of lowering LDL-C levels takes time with only modest effects observed during the first year of treatment. In the FOURIER trial the reduction of cardiovascular death, myocardial infarction, or stroke was 16% during the first year but was 25% beyond 12 months. Thus, long-term benefit may be greater than observed during the study.

ODYSSEY TRIAL

SUMMARY OF OUTCOME TRIALS

It should be noted that that the duration of the PCSK9 outcome trials were relatively short and it is well recognized from previous statin trials that the beneficial effects of lowering LDL-C levels takes time with only modest effects observed during the first year of treatment. In the FOURIER trial the reduction of cardiovascular death, myocardial infarction, or stroke was 16% during the first year but was 25% beyond 12 months. In the ODYSSEY trial the occurrence of cardiovascular events was similar in the alirocumab and placebo group during the first year of the study with benefits of alirocumab appearing after year one. Thus, the long-term benefits of treatment with a PCSK9 inhibitor may be greater than that observed during these relatively short-term studies.

GLAGOV TRIAL

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Effect Of Fibrates On Cardiovascular Outcomes

There have been a number of studies that have examined the effect of a variety of different fibrates on cardiovascular disease. We will describe the major studies below.

A separate meta-analysis has focused on the effect of fibrates on cardiovascular disease in patients with pre-existing disease . It included 13 trials involving a total of 16,112 participants. For the primary composite outcome of non-fatal stroke, non-fatal myocardial infarction, and vascular death, fibrate therapy significantly decreased risk by 12% 0.88, 95% 0.83 to 0.94). Fibrates were effective for preventing myocardial infarction . Fibrates were not effective in lowering all-cause mortality , death from vascular causes , or stroke events . Since clofibrate has been discontinued due to safety concerns, the data were reanalyzed excluding clofibrate trials. Without clofibrate, fibrates no longer significantly reduced the primary outcome but were still effective in preventing myocardial infarctions . Subgroup analyses showed the benefit of fibrates on the primary composite outcome to be consistent irrespective of age, gender, and diabetes mellitus.

SUMMARY OF OUTCOME STUDIES

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What Are The Causes Of High Cholesterol

The tendency toward high cholesterol appears to be genetic although diet also influences cholesterol levels. Other factors that can influence cholesterol levels include being overweight and being physically inactive. The older you get, the more likely your cholesterol levels are to rise. Before menopause, women tend to have lower cholesterol levels than men of the same age, but after menopause, womens LDL levels often increase.

There is considerable controversy over whether high cholesterol is in itself a cause of heart disease , or a symptom of an inflammatory condition that is the true cause of heart disease . According to the latter theory, chronically high levels of inflammation creates small lesions on arterial walls the body sends LDL to heal those lesions, but it ultimately accumulates and oxidizes, causing blockages. From this perspective, the best lifestyle approach to lower cardiovascular disease risk is to lower inflammation in the body rather than LDL levels.

The two theories are not mutually exclusive they may both be true to some extent.

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When To See A Doctor

High cholesterol has no symptoms. If youâve not sure about your levels, ask your doctor. They may do a simple blood test to check it. Doctors recommend that all adults older than 20 years old should have their cholesterol levels checked every 4 to 6 years.

If you have high cholesterol, your doctor may ask you to change your diet and make lifestyle changes to get it under control. If that doesnât work, you doctor may prescribe medications to help.

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Best Supplements To Lower Cholesterol

What are triglycerides?Triglycerides are a type of fat found in your blood.

After you eat, your body converts the calories that you dont need into triglycerides and stores them in your fat cells to be used for energy later.

Triglyceride levelsWhile triglycerides are an important energy supply for your body, having too many triglycerides in your blood can increase your risk of heart disease. Below are guideline triglyceride levels for adults in milligrams per deciliter .

Category Triglyceride level High 200499Very high 500 and aboveAbout 25.9% of adults in the United States have elevated blood triglycerides, which is classified as having triglyceride levels over 150 mg/dL .

Having obesity or unmanaged diabetes, regularly drinking alcohol, and following a high calorie diet can all contribute to high blood triglyceride levels.

Ways to lower triglyceridesYou can lower your triglyceride levels through a variety of dietary and lifestyle changes.

Aim for a healthy-for-you weightWhenever you eat more calories than your body needs, your body turns those calories into triglycerides and stores them in fat cells.

Working toward a moderate body weight by consuming fewer excess calories can be an effective way to lower your blood triglyceride levels.

In fact, research has shown that losing even 510% of your body weight can significantly reduce your triglyceride levels .

Limit your sugar intakeAdded sugar is a big part of many peoples diets.

Tree nuts include:

How Long Does It Take To Reduce Cholesterol

Cholesterol drops over time, not suddenly, after a few days of healthier living. There is no set period in which cholesterol is guaranteed to drop.

Cholesterol-lowering drugs usually produce a change in LDL within 6 to 8 weeks. It is possible for lifestyle changes to change cholesterol levels within weeks. However, it may take longer,

• Total cholesterol: less than 200 milligrams per deciliter
• LDL bad cholesterol: less than 100 mg/dL
• HDL good cholesterol: higher than 60 mg/dL
• Triglycerides: less than 150 mg/dL

According to an article in the journal Circulation, the American College of Cardiology and the American Heart Association recommend using statins to lower cholesterol in people with cholesterol higher outside of these levels.

However, they also recommend doctors consider a persons cholesterol levels and overall risk of cardiovascular disease before prescribing a cholesterol-lowering medication.

The AHA recommends that people with atherosclerotic cardiovascular disease get high-intensity statin therapy maximally tolerated statin therapy to lower LDL by at least 50%.

The AHA also recommends high-intensity statin therapy for individuals with severe primary hypercholesterolemia .

There are a number of habit changes a person can incorporate into their daily routines in order to gradually and consistently lower their LDL levels over time. Including:

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