Medications To Treat High Cholesterol
For most people who need medication to manage high cholesterol, doctors will prescribe statins. Statins, also known as HMG CoA reductase inhibitors, are a class of drugs that prevent cholesterol from forming in the liver, where both LDL and HDL cholesterol are made. This lowers the amount of cholesterol circulating in the blood. They are most effective at lowering LDL cholesterol but can also lower triglycerides and HDL cholesterol.
If you have certain conditions, or if statins arent working to decrease your high cholesterol sufficiently, your doctor may prescribe one of these other cholesterol-lowering medications:
- PCSK9 Inhibitors A newer type of medicine, PCSK9 inhibitors bind to and inactivate a protein on certain liver cells, which then lowers LDL cholesterol. Administered by injection, they are often used in patients with high cholesterol that doesnt respond to statins or people with familial hypercholesterolemia.
- Selective Cholesterol Absorption Inhibitors The most commonly used nonstatin agent, according to the AHA, selective cholesterol absorption inhibitors prevent cholesterol from being absorbed in the intestine. This means less cholesterol is delivered to the liver and, ultimately, the blood.
- Bile Acid Sequestrants Also known as bile-acid-binding agents, these drugs work by removing bile acids from the liver. Since LDL cholesterol is needed to make bile acids, the body then breaks down more LDL cholesterol particles.
When Should My Cholesterol Levels Be Tested
Your GP may recommend that you have your blood cholesterol levels tested if you:
- have been diagnosed with coronary heart disease, stroke or mini stroke , or peripheral arterial disease
- have a family history of early cardiovascular disease
- have a close family member who has a cholesterol-related condition
- are overweight
Increase The Amount Of Fiber In Your Diet
Most of us do not get enough fiber in our diet. The recommended amount is 25-35 grams of dietary fiber per day. Dietary fiber is a type of carbohydrate that the body cannot digest. As fiber passes through the body, it affects the way the body digests foods and absorbs nutrients. Fiber can help reduce your LDL cholesterol level. A fiber-rich diet can also help control blood sugar, promote regularity, prevent gastrointestinal disease and help you manage your weight.
There are two types of dietary fiber: soluble and insoluble. To receive the greatest health benefit, eat a wide variety of all high-fiber foods. Refined foods, like white bread, white pasta and enriched cereals are low in fiber. The refining process strips the outer coat from the grain, which reduces the amount of fiber thats left.
The best sources of fiber are whole grains, fruits, vegetables and legumes .
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Eat Fibre To Lower Cholesterol
Eating high-fibre food can also help to lower your cholesterol. Fibre helps reduce the amount of cholesterol that is absorbed into the blood stream from your intestine.
- Make sure you get at least five portions of fruit and vegetables a day as these contain fibre along with other nutrients
- Eat plenty of other high fibre foods like pulses oats and seeds.
- Choose more wholegrain foods when you can, such as brown or granary bread over white.
How Is Cholesterol Measured
Most people with high cholesterol feel perfectly well and often have no symptoms. The best way to find out if your cholesterol is high is to have a blood test .
Visit your GP to determine whether you need to lower your cholesterol level and what action to take.
GPs can also do a heart health check, that calculates your heart disease and stroke risk.
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Let South Denver Cardiology Associates Help
If you are trying to improve your health by cutting down on your cholesterol, South Denver Cardiology Associates offers many programs that might be useful. This includes our gym and various exercise classes.
We can also help you assess the seriousness of your heart problems with extensive diagnostic testing options. For example, we offer a heart scan that looks at the calcification of your heart arteries. This can help you understand your heart risks in the near term.
To learn more about the benefits of working with South Denver Cardiology, please call 303-744-1065 or use our online form to schedule an appointment today.
Timeline For Lowering Cholesterol
Lowering cholesterol can take time, but its worth it.
Whether using medication, lifestyle changes, or a combination of the two, many people see improvement in their cholesterol levels within a few weeks.
Others experience notable changes after a few months.
Thats why its important to keep the big picture in mind, ignore quick fixes, and make changes you can live with long term: In order to lower high cholesterol and improve heart health for good, you need to create new habits.
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How To Lower Cholesterol Quickly And Naturally
If youve been diagnosed with high cholesterol levels, your doctor may have given you a deadline for lowering it before opening up the conversation to medications to control your cholesterol.
This sudden change in your health statusand the pressure to make potentially huge lifestyle changes in a short amount of timemay feel overwhelming, especially if youre unfamiliar with the causes of high cholesterol, confused about what your cholesterol numbers mean, or at a loss about where and how to start making necessary changes to improve your cholesterol.
Welcome to the Forward guide to helping you get those numbers down naturally. Here, we take a look at the three overarching lifestyle factors that have the biggest impact on cholesteroldiet, exercise, and stress. Understanding how these affect your cholesterol is the first step to lowering it. After each section, youll find a link to a related guide offering practical and actionable tips for changing your eating and exercise habits and reducing stress.
Signs And Symptoms Of High Cholesterol
Typically, high cholesterol doesnt cause any symptoms until it causes a medical emergency, like a heart attack or stroke. These heart-disease-related events dont occur until high cholesterol levels have led to fatty plaque building up in the arteries. In turn, this leads to a narrowing of the arteries and a change in the makeup of the arterial lining, also known as heart disease.
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Plant Sterols Can Lower Cholesterol Levels
Plant sterols are found naturally in plant foods including sunflower and canola seeds, vegetable oils and in nuts, legumes, cereals, fruit and vegetables. Some margarine and milks have concentrated plant sterols added to them. Margarines enriched with plant sterolslower LDL cholesterol in most people if the correct amount is eaten .
What Lifestyle Changes Can I Make To Help Improve My Cholesterol Levels
Exercise can raise HDL cholesterol levels. It can also reduce levels of LDL cholesterol and triglycerides . Try to work out for 30 minutes, 4 to 6 times a week. Your workout should be moderate to vigorous. Make sure you talk to your doctor before starting an exercise plan.
Lose weight if youre overweight.
Being overweight can raise your cholesterol levels. Losing weight, even just 5 or 10 pounds, can lower your total cholesterol, LDL cholesterol, and triglyceride levels.
If you smoke, quit.
Smoking lowers your HDL cholesterol. Even exposure to second-hand smoke can affect your HDL level. Talk to your doctor about developing a plan to help you stop smoking.
Eat a heart-healthy diet.
- Eat plenty of fresh fruits and vegetables.Fruits and vegetables are naturally low in fat. They add flavor and variety to your diet. They are also the best source of fiber, vitamins, and minerals for your body. Aim for 5 cups of fruits and vegetables every day. This should not include potatoes, corn, or rice. These count as carbohydrates.
- Pick good fats over bad fats. Fat is part of a healthy diet, but there are bad fats and good fats. Bad fats include saturated and trans fats. They are found in foods such as:
- Fats in whole milk dairy products.
Limit the amount of saturated fat in your diet. Avoid trans fat completely.
In addition to fiber, whole grains supply B vitamins and important nutrients not found in foods made with white flour.
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What Causes High Cholesterol
The most common cause of high cholesterol is an unhealthy lifestyle. This can include:
- Unhealthy eating habits, such as eating lots of bad fats. One type, saturated fat, is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods. Another type, trans fat, is in some fried and processed foods. Eating these fats can raise your LDL cholesterol.
- Lack of physical activity, with lots of sitting and little exercise. This lowers your HDL cholesterol.
- Smoking, which lowers HDL cholesterol, especially in women. It also raises your LDL cholesterol.
Genetics may also cause people to have high cholesterol. For example, familial hypercholesterolemia is an inherited form of high cholesterol. Other medical conditions and certain medicines may also cause high cholesterol.
Pharmacokinetics And Drug Interactions
Statins have different pharmacokinetic properties which can explain clinically important differences in safety and drug interactions . Most statins are lipophilic except for pravastatin and rosuvastatin, which are hydrophilic. Lipophilic statins can enter cells more easily but the clinical significance of this difference is not clear. Most of the clearance of statins is via the liver and GI tract . Renal clearance of statins in general is low with atorvastatin having a very low renal clearance making this particular drug the statin of choice in patients with significant renal disease. The half-life of statins varies greatly with lovastatin, pravastatin, simvastatin, and fluvastatin having a short half-life while atorvastatin, rosuvastatin, and pitavastatin having a long half-life . In patientâs intolerant of statins, the use of a long-acting statin every other day or 2 times per week has been employed. Short acting statins are most effective when administered in the evening when HMG-CoA reductase activity is maximal while the efficacy of long-acting statins is equivalent whether given in the AM or PM . In patients who prefer to take their statin in the morning one should use a long-acting statin.
Thus, despite the excellent safety record of statins, careful attention must be paid to the potential drug-drug interactions. For additional information see Kellick et al .
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Ways To Lower Your Cholesterol Without Medication
Cholesterol is a waxy substance in your blood and is also found in certain foods. Ideally, your total cholesterol levels will fall under 200 milligrams per deciliter . Your LDL, or bad cholesterol, levels should fall under 100 mg/dL. And your HDL, or good cholesterol, should stay at 40 mg/dL or higher. If you have high cholesterol levels, changing your lifestyle can go a long way.
Dr. Javier Sosa and our team at Woodlands Primary Healthcare provide blood tests to help identify cholesterol-related risk factors. We can also make lifestyle recommendations that suit your specific needs.
Here are nine ways you can lower your cholesterol levels without medication:
Who Should Be Treated
In a sense, everyone. Thats 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 its 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 individuals risk profile influences the choice of therapy.
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How Can I Accelerate My Results
Sometimes diet, exercise, weight management, and smoking cessation are simply not enough or can not produce the quick results needed by these people in the high-risk category of heart attack or stroke. In these cases, your doctor will prescribe you probably one of the several types of cholesterol-lowering medications. The most likely candidate will be one of the statins which significantly reduce the amount of cholesterol produced by the liver. Statins can reduce LDL by 30 to 60 percent in a matter of weeks. Although they can produce impressive results, they come with a long list of side effects that need to be discussed with your doctor before making a decision.
Drink Alcohol In Moderation
Moderate alcohol consumption has been shown to increase your levels of good cholesterol, which, in turn, can reduce your levels of bad cholesterol.
The effects arent enough to encourage people to start drinking, but it does mean that perhaps its a good idea not to cut all alcohol from your diet just for the sake of reducing calories.
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How Fast Do Statins Work
Many doctors are prescribing statins to lower cholesterol in their patients. High cholesterol is one of the many risk factors that are associated with heart disease. Statins generally act quickly to reduce cholesterol but results vary from patient to patient.
Introduced to the market in 1987, statins have become one of the most widely used medications to treat high cholesterol and controlling cholesterol is one main way to prevent heart disease.
How Statins Work
In many patients, healthy diets and exercise is not enough to lower cholesterol. These patients may be put on statin therapy. Statins work by reducing the formation of artery-clogging plaque. They often reduce LDL or bad cholesterol by up to 50% and increase a patients HDL or good cholesterol by up to 15%.
Maximizing Statin Results
The effectiveness of statins can be affected by patient lifestyle. Patients who make healthy lifestyle modifications can often see a reduction in their cholesterol as early as two weeks after starting statin therapy. A diet that is low in saturated fats and cholesterol slows down the formation of fatty plaque more quickly than a patient who continues a diet high in fats.
Statins and Heart Disease
In combination with a healthy lifestyle, statins lower cholesterol levels and also reduce the risk of heart attack, stroke and other cardiovascular events.
Stress Substance Abuse And Cholesterol
Stress is a well-known factor for substance abuse that can lead to all sorts of unhealthy behaviors, including smoking, drinking, using drugs, or overeating in an attempt to self-medicate the physical and mental discomfort stress causes.
While these vices may provide short-term relief, they can do serious damage to your physical and mental health over timeincluding increasing your blood pressure and cholesterol and contributing to anxiety, depression, or addiction.
Smoking cigarettes, cigars, and pipes is a major cause of high cholesterol, high blood pressure, and heart disease. Thousands of harmful chemicals in cigarettes change your blood chemistry, which increases the amount of plaque that builds up in your arteries. Smoking thickens the blood and hardens the plaque, making your heart work extra hard to get the oxygen-rich blood where it needs to go. Blood clots form more easily and can lead to a heart attack or stroke.
Excessive alcohol consumption
While alcohol doesnt contain cholesterol, it adds extra calories andin some casescarbs to your diet. The excess calories and carbs turn into triglycerides and LDL cholesterol. While moderate alcohol usedefined as no more than one drink per day for women or two per day for menis linked to higher good HDL cholesterol levels, heavy use is associated with numerous health problems, including high blood pressure, heart attack, and stroke.
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What Is The Pritikin Diet
The Pritikin diet significantly reduces saturated fatty acids trans fatty acids , and dietary cholesterol. It also increases dietary fiber in the form of natural, nutrient-rich foods like fruits, vegetables, whole grains, and beans. This is the healthiest way to lower cholesterol, points out cardiologist Ronald Scheib, MD, physician and educator at the Pritikin Longevity Center in Miami, where the Pritikin Program has been taught since 1975.
Treatment And Medication Options For High Cholesterol
Although having high cholesterol numbers can contribute to the long-term risk of heart attack and stroke, you can lower your cholesterol through changes in your lifestyle habits, including adopting a heart-healthy diet, increasing your physical activity level, and quitting smoking. These long-term lifestyle changes can also prevent your cholesterol levels from changing in the first place.
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Why Should I Lower My Cholesterol
Evidence strongly indicates that high cholesterol can increase the risk of:
- narrowing of the arteries
- transient ischaemic attack often known as a “mini stroke”
- peripheral arterial disease
This is because cholesterol can build up in the artery wall, restricting the blood flow to your heart, brain and the rest of your body. It also increases the risk of a blood clot developing somewhere in your body.
Your risk of developing coronary heart disease also rises as your blood’s cholesterol level increases. This can cause pain in your chest or arm during stress or physical activity .
Eat A Plant Based Diet
The first step may surprise you because its not demanding at all. Its a step, however, that many never take or fail to sustain. Build a relationship with your physician. Let him/her know that you want to know how to get off statin drugs and where you stand in regard to heart-healthy targets. Then, in consultation with your doctor, put together a game plan for doing so. As Ive said, this will demand lifestyle modification. Without changing the way you live, theres no solid reason to get off your statin medication
Part of this game plan must be eating a plant-based diet. Depending on a patients particular profile, I recommend either the Dean Ornish Heart Disease Reversal Diet or the South Beach Diet. If you have known heart disease, the Ornish diet is better because it most effectively cleanses the system of excess fat. The South Beach Diet is usually for those with risk factors but no known heart disease. This diet allows more latitude and can still get a person to the recommended targets. Although the Ornish Diet puts no restrictions on calorie intake mainly because its hard to consume too many calories eating fruits and vegetables, youll need to limit your calories on the South Beach Diet or a Mediterranean diet . A typical unrestricted diet for the average adult contains about 2,400 calories per day. Aim to keep your calorie intake between 1,500 and 1,800 calories. The lower end is for women the higher end is for men.
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