Can Exercise And Diet Lower Your Cholesterol Enough
Thereâs no doubt that a healthy lifestyle helps lower cholesterol. The question is whether it can lower your levels enough â and that depends on how high your levels are and what your doctor has set as your goal.
- Eating a heart-healthy diet can lower LDL cholesterol at least 10%.
- If you lose 5% to 10% of your body weight, you can cut LDL cholesterol 15%, and reduce triglycerides 20%.
- If you exercise at a moderate intensity — meaning you have enough breath to talk but not sing — for at least 2 Â½ hours a week, you can further cut triglycerides 20% to 30%.
Thatâs a great start, says Michael Miller, MD, director of the Center for Preventive Cardiology at the University of Maryland Medical Center. “Lifestyle changes certainly are the cornerstone of cholesterol reduction.”
To get your cholesterol down to lower your risk of cardiovascular disease your doctor may recommend, though, that you still need a statin. These powerful cholesterol-lowering medicines include atorvastatin , pravastatin , and simvastatin , among others.
Increase Your Dietary Fiber
Dietary fiber helps lower your triglyceride levels in three ways:
Fiber is found in a wide variety of plant foods and you need both soluble and insoluble to gain all the benefits.
Soluble fiber sources include psyllium husks, artichoke, asparagus, winter squash, Brussels sprouts, broccoli, onion, carrots, beans, legumes, blueberries, and nuts.
Insoluble fiber sources include spinach, Brussels sprouts, broccoli, winter squash, bran, and flaxseeds, among other fruits and veggies.
Your fiber intake should be at least 25 to 35 grams per day.
What Causes High Cholesterol And Why Is It Harmful
People with high cholesterol or triglycerides have abnormally high levels of fats in their blood. Cholesterol is produced in the liver and is used by cells throughout the body. Its found in fatty foods such as eggs, red meat and cheese. Triglycerides are the result of extra calories stored in the body when not used for energy. Theyre produced by the liver but also come from some foods including red meat, dairy, refined carbohydrates or sugars and alcohol.
Low-density lipoprotein is known as the bad cholesterol because it can result in a buildup of plaque known as atherosclerosis, which leads to blockages in your blood vessels and increases your risk for heart disease or stroke.
In general, LDL below 100 milligrams/deciliter is considered good. However, recent studies show that LDL levels below 30-50 mg/dL are even more effective in preventing heart disease. Triglyceride levels less than 150 mg/dL are considered good, although less than 100 is ideal.
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Do Statins Cause Muscle Pain And Weakness
Muscle aches occur in about 10 percent of people who take statins. Its the most common side effect of statins, but another way to look at it is that nine out of 10 patients dont experience it at all.
When patients do have muscle pain:Actual muscle damage occurs in only 1 in 10,000 patients. In the rare event that muscle damage occurs, it is almost always reversible. To correct it while still protecting you from heart attack or stroke, we can adjust your medication or try a different statin. There also are many strategies to effectively manage muscle symptoms while continuing to take your medication.
If you experience muscle pain while taking a statin, dont stop taking it without first talking with your doctor. For almost all patients, were able to find an effective medication that the body can tolerate. If you simply cant tolerate statins, there are other cholesterol medications we can prescribe.
- The symptom is often resolved by adjusting the medication dosage or switching to a different statin.
- Occasionally, the statins have to be stopped altogether.
- When the medication is switched or stopped, the symptoms go away and there is no damage to the muscle.
What Causes High Triglycerides
Aside from consuming a high-fat and/or high-carb diet, other lifestyle factors can contribute to high triglycerides, specifically excess weight, lack of exercise, drinking too much alcohol and smoking. Dr. Malaney adds that it can also be a side effect of certain medications, such as some birth control pills, beta blockers, antipsychotics medications, and corticosteroids.
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Rosuvastatin And Atorvastatin Are The Best At Lowering Ldl Cholesterol
Heres the evidence backing this:
A 6-week clinical trial compared rosuvastatin against atorvastatin, pravastatin, and simvastatin and found that it lowered total cholesterol significantly more than all others, and lowered triglycerides significantly more than simvastatin and pravastatin.
A 54-week clinical trial compared atorvastatin with fluvastatin, lovastatin, and simvastatin and found that atorvastatin was better at lowering LDL cholesterol than the other medications.
A systematic review of 75 clinical trials found that rosuvastatin and atorvastatin were the only statins that lowered LDL cholesterol by more than 40% .
Who Should Be Treated
In a sense, everyone. That’s because no cholesterol level is too good. But people with unhealthy levels should work hard to improve, while those with ideal results can afford to relax a bit. Table 1 shows the goals established by the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults.
Cholesterol is a crucial determinant of cardiovascular health, but it’s only one. In fact, smoking is even more dangerous than unhealthy cholesterol levels, and high blood pressure, diabetes, and lack of exercise are nearly as harmful. Because each risk factor adds to the harm of others, people with the most risk need the most vigorous treatment. Table 2 shows how an individual’s risk profile influences the choice of therapy.
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Dangers Of Statin Drugs: What You Havent Been Told About Popular Cholesterol
Hypercholesterolemia is the health issue of the 21st century. It is actually an invented disease, a problem that emerged when health professionals learned how to measure cholesterol levels in the blood. High cholesterol exhibits no outward signsunlike other conditions of the blood, such as diabetes or anemia, diseases that manifest telltale symptoms like thirst or weaknesshypercholesterolemia requires the services of a physician to detect its presence. Many people who feel perfectly healthy suffer from high cholesterolin fact, feeling good is actually a symptom of high cholesterol!
Doctors who treat this new disease must first convince their patients that they are sick and need to take one or more expensive drugs for the rest of their lives, drugs that require regular checkups and blood tests. But such doctors do not work in a vacuumtheir efforts to convert healthy people into patients are bolstered by the full weight of the US government, the media and the medical establishment, agencies that have worked in concert to disseminate the cholesterol dogma and convince the population that high cholesterol is the forerunner of heart disease and possibly other diseases as well.
The drugs that doctors use to treat the new disease are called statinssold under a variety of names including Lipitor , Zocor , Mevacor and Pravachol .
Cholesterol Levels In Dialysis Patients
In a study of dialysis patients, those with higher cholesterol levels had lower mortality than those with low cholesterol.51 Yet the authors claimed that the inverse association of total cholesterol level with mortality in dialysis patients is likely due to the cholesterol-lowering effect of systemic inflammation and malnutrition, not to a protective effect of high cholesterol concentrations. Keeping an eye on further funding opportunities, the authors concluded: These findings support treatment of hypercholesterolemia in this population.
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How Are Doctors Sure That Statins Really Are Safe And Beneficial
Statins have been studied more than nearly any other drug that people take. In fact, more than 170,000 people who take statins have been studied in detail and for extended periods of time. We certainly know the benefits of statins.
We also understand the risks of statins. In some instances, after doctors have prescribed a drug for 10 years or more, it is taken off the market because of unforeseen, adverse side effects. Weve been prescribing statins since the 1990s for patients at high risk for stroke and heart disease. With statins, the side effects actually are well known. But how can we put that in perspective?
Any focus on statin side effects needs to be counterbalanced by the fact that statins reduce peoples risk of dying from heart attack, heart disease, or stroke. Data from the 2008 JUPITER Trial suggest a 54 percent heart attack risk reduction and a 48 percent stroke risk reduction in people at risk for heart disease who used statins as preventive medicine. The data are not speculative rather, they reflect statins real potential to save lives and avoid illness.
There are many varieties of brand name and generic statins available. All statins work in more or less the same way to lower bad cholesterol in patients at high risk for cardiac events.
Below are a few of the common brand names you may recognize, along with their generic counterparts:
What Side Effects Do Statins Cause
Because theyre prescribed to so many people, the side effects of statins are well-known and continue to be studied.
Muscle pain and weakness: Partly because of the widespread media attention to the issue, people taking statins report muscle pain or weakness much more frequently than would be expected based on research studies. Just because you have muscle pain doesnt mean that its caused by a statin. There are many other causes of muscle pain. To get a better idea of whether the statin is the culprit, try a few cycles of being on and off the statin. For example, you could stop the statin for a month and see if the pain goes away. Then take the statin again for another month to see if it comes back. Self-testing like this can be helpful to figure out whether the statin is the cause of your pain. Wed always recommend talking to your healthcare provider before making any changes to your medication, though. The chance of having severe muscle damage confirmed by blood tests is less than 1 in 1,000.
Diabetes: Statins increase the risk of developing diabetes by a very small amount . When it does happen, it usually affects people who already have other risk factors for diabetes. The benefit of taking statins for preventing cardiovascular disease far outweighs the risk of developing diabetes.
Liver damage: Statins cause painless abnormalities in liver blood tests in approximately 1 out of 100 patients. The risk of significant liver damage is only 1 in 100,000.
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How To Safely Come Off Statins
Its possible for some people to stop taking statins safely, but it can be especially risky for others. For instance, if you have a history of heart attack or stroke, its not recommended that you stop taking these drugs. This is because youre more likely to have another such problem when you discontinue statins.
However, if you dont have a history of heart attack or stroke and you want to stop taking statins, your first step should be to talk to your doctor. They can help you find out what your risk factors are, and if stopping statins is a safe move for you.
If your doctor thinks that you could safely stop taking your statin, they can suggest a plan for it. This plan may involve stopping statins entirely, or it may involve reducing your statin usage. Another option is to continue taking the statin but to add a supplement. One of these options is likely to address whatever problems taking statins causes for you.
If your doctor will be helping you stop taking statins entirely, some options they might suggest include switching to a different drug or adopting certain lifestyle changes.
Who Should Take Statins
Whether you need to take statins depends on your cholesterol levels and overall heart health. Cholesterol is the waxy substance found in the blood, and high levels of LDL or bad cholesterol can put you at risk of plaque buildup.
In the initial stages, a high LDL cholesterol level can be managed by lifestyle changes such as a healthy diet, exercise, and quitting smoking. However, if these measures fail or are not enough, your doctor may prescribe statins to lower your risk of developing cardiovascular disorders.
Pregnant or breastfeeding women should not take statins, and women trying to conceive must discontinue use. Generally, statins should be discontinued at least 6 weeks and preferably 12 weeks before planned conception.
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Even With Statins High Triglycerides May Increase Risk Of Second Stroke
Stroke can have many causes. An atherothrombotic stroke is caused by a clot that forms from plaques that build up within blood vessels in the brain. A new study suggests that people who have this type of stroke who also have higher levels of triglycerides, a type of fat, in their blood may have a higher risk of having another stroke or other cardiovascular problems one year later, compared to people who had a stroke but have lower triglyceride levels. The research is published in the March 16, 2022, online issue of Neurology, the medical journal of the American Academy of Neurology. The study found an association even when people were taking statin drugs meant to lower triglycerides and protect against heart attack and stroke.
Elevated triglyceride levels are thought to contribute to hardening of the arteries and increased risk of heart attack, heart disease and stroke.
“Our study suggests that for people who had atherothrombotic stroke, having elevated levels of triglycerides in their blood is a risk factor for having another stroke or other cardiovascular problems in the future, and we found that to be true even if the person is on statin therapy,” said study author Takao Hoshino, MD, of the Tokyo Women’s Medical University in Japan. “The good news is that statin medications are just one therapy for high triglyceridesdiet and exercise can also be effective ways to reduce the levels in your blood at little or no cost.”
What Qualifies As High Triglycerides
According to MedlinePlus , blood levels less than 150 mg/dL fall under the triglycerides normal range, while anything higherknown as hypertriglyceridemiacan increase risk for heart disease. Elevated triglycerides can also be a very early sign of diabetes, states Kristin Thomas, MD, a board-certified internist and co-founder of Foxhall Medicine in Washington, DC.
Extremely high triglyceridesblood levels over 500 mg/dLmay be due to a genetic disorder and can increase the risk of pancreatitis, along with heart disease, including atherosclerosis , Dr. Thomas, co-author of You Can Prevent A Stroke, explains. It can be seen alone or in association with many other conditions, as well, such as metabolic syndrome, hypothyroidism, fatty liver disease and kidney disease, Dr. Malaney says.
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Whos More Likely To Have Side Effects From Statins
Not everyone who takes a statin has side effects. According to a , youre more likely to experience side effects if you:
- were assigned female at birth
- are 65 years old or older
- have type 1 or 2 diabetes
- take multiple medications to lower your cholesterol
- have a smaller body frame
- have liver or kidney disease
- consume too much alcohol
If youre experiencing side effects, a doctor or other healthcare professional may want you to try another statin, change your dosage, or try a different medication.
Prescription Drugs For Cholesterol And Triglycerides
From statins like Lipitor to PCSK9 inhibitors like Repatha to niacin and beyond, several kinds of medications are regularly prescribed to treat high cholesterol and triglyceride levels.
Which is most appropriate for you depends on several factors, but its likely your healthcare provider will want you to begin taking prescription medication if diet and exercise are not enough to lower your levels, or if your risk for cardiovascular disease is particularly elevated.
This article will help you learn about the possible prescription options your healthcare provider might suggest so you can take an active role in your treatment discussions and decisions.
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How Do Fibrate Drugs Work
Fibrates reduce the amount of very-low-density lipoprotein your liver makes. VLDL particles carry triglycerides to other parts of your body. By limiting how much VLDL your body makes, these medicines lower your triglyceride levels.
Fibrate drugs also increase the amount of apolipoproteins A-I and A-II your liver makes. These two proteins help create HDL cholesterol. Creating more of these proteins increases your HDL cholesterol levels.
People With Cardiovascular Disease Caused By Atherosclerosis
This includes people who have had:
A heart attack or other problems from blockage of the coronary arteries of the heart
A stroke or mini-stroke or blockage of carotid arteries in the neck
Leg pain caused by blockage of peripheral arteries
Aneurysm or bulging of the abdominal aorta
The goal of using statins is to prevent further problems, like a second heart attack.
Muscle Pain And Weakness
The most common side effect is muscle pain and weakness, a condition called rhabdomyolysis, most likely due to the depletion of Co-Q10, a nutrient that supports muscle function. Dr. Beatrice Golomb of San Diego, California is currently conducting a series of studies on statin side effects. The industry insists that only 2-3 percent of patients get muscle aches and cramps but in one study, Golomb found that 98 percent of patients taking Lipitor and one-third of the patients taking Mevachor suffered from muscle problems.4 A message board devoted to Lipitor at forum.ditonline.com contained more than 800 posts, many detailing severe side effects. The Lipitor board at www.rxlist.com contains more than 2,600 posts .
The test for muscle wasting or rhabdomyolysis is elevated levels of a chemical called creatine kinase . But many people experience pain and fatigue even though they have normal CK levels.5
John Altrocchi took Mevacor for three years without side effects then he developed calf pain so severe he could hardly walk. He also experienced episodes of temporary memory loss.
Active people are much more likely to develop problems from statin use than those who are sedentary. In a study carried out in Austria, only six out of 22 athletes with familial hypercholesterolemia were able to endure statin treatment.9 The others discontinued treatment because of muscle pain.