When there is too much cholesterol in your blood, it builds up in the walls of your arteries, causing a process called atherosclerosis, a form of heart disease. The arteries become narrowed and blood flow to the heart muscle is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.
How to Lower Your Cholesterol
Cholesterol is a waxy, fat like substance that your body needs to function normally. Cholesterol is naturally present in cell walls or membranes everywhere in the body, including the brain, nerves, muscles, skin, liver, intestines, and heart.
Your body uses cholesterol to produce many hormones, vitamin D, and the bile acids that help to digest fat. It takes only a small amount of cholesterol in the blood to meet these needs. If you have too much cholesterol in your bloodstream, the excess may be deposited in arteries, including the coronary (heart) arteries, where it contributes to the narrowing and blockages that cause the signs and symptoms of heart disease. Normally all of the colesterol the body need made on liver, but cholesterol also enter to body from food, such as animal-based foods likes milk, eggs, meat. Too much cholesterol in your body is a major risk factor for heart disease.
How Does High Cholesterol Cause Heart Disease?
When there is too much cholesterol in your blood, it builds up in the walls of your arteries, causing a process called atherosclerosis, a form of heart disease. The arteries become narrowed and blood flow to the heart muscle is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.
There are two forms of cholesterol:
1. Low-density lipoprotein (LDL or "bad" cholesterol)
Triglycerides are another fat in our bloodstream. Research is now showing that a high levels of triglycerides is also linked to heart disease.
What Are the Symptoms of High Cholesterol?
High cholesterol itself does not cause any symptoms; so many people are unaware that their cholesterol levels are too high. Therefore, it is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it.
What Numbers Should I Look For?
Some recommend that everyone over the age of 20 should get their cholesterol levels measured at least once every 5 years. The test that is performed is a blood test called a lipoprotein profile. That includes:
*/ HDL (good) cholesterol protects against heart disease, so higher HDL number is better
What Affects Cholesterol Levels?
A variety of factors can affect your cholesterol levels. They include:
The main goal in treating high cholesterol is to lower your LDL. To lower cholesterol, eat a heart-healthy diet, exercise regularly, and maintain a healthy weight. Some may also need to take cholesterol lowering drugs.
Doctors determine your "goals" for lowering LDL based on the number of risk factors you have for heart disease.
Major risk factors include: age (men 45 years and older, women 55 years and older), cigarette smoking, high blood pressure, an HDL less than 40 mg/dL, family history of premature heart disease in a male first degree relative less than 55 years and female first degree relative less than 65 years of age.
Cholesterol-lowering drugs include:
Statins
Statins block the production of cholesterol in the liver itself. They lower LDL, the "bad" cholesterol, and triglycerides and have a mild effect in raising HDL, the "good" cholesterol. These drugs are the first line of treatment for most people with high cholesterol. Side effects can include intestinal problems, liver damage, and in a few people, muscle tenderness or weakness.
Examples of statins include:
Caduet is a new drug that is a combination of a statin (Lipitor or atorvastatin) and a blood pressure-lowering drug called amlodipine (Norvasc). Vytorin is a combination of a statin and a cholesterol absorption inhibitor((simvastatin + ezetimibe).
Niacin
Niacin is a B-complex vitamin. It's found in food, but is also available at high doses by prescription. It lowers LDL cholesterol and raises HDL cholesterol. These drugs also lower elevated triglycerides. The main side effects are flushing, itching, tingling, and headache, yet aspirin can reduce many of these symptoms. However, speak with your doctor first. Niacin or nicotinic acid, includes the brand names Niacor, Niaspan, or Slo-niacin. Over-the-counter preparations include extended-release, timed-release, and controlled-release. Niacin found in dietary supplements should not be used to lower cholesterol. Your doctor or lipid specialist will let you know what type of niacin is best for you.
Bile Acid Sequestrants
These drugs work inside the intestine, where they bind to bile and prevent it from being reabsorbed into the circulatory system. Bile is made largely from cholesterol, so these drugs work by reducing the body's supply of cholesterol, thus lowering total and LDL cholesterol. The most common side effects are constipation, gas, and upset stomach. Examples of bile acid resins include:
Fibrates lower triglyceride levels and can increase HDL and lower LDL cholesterol. The mechanism of action is not clear but it is thought that fibrates enhance the breakdown of triglyceride-rich particles and decrease the secretion of certain lipoproteins. In addition, they induce the synthesis of HDL.
Examples of fibrates include:
Zetia (ezetimibe) works to lower LDL by inhibiting the absorption of cholesterol in the intestines. Vytorin is a newer drug that is a combination of Zetia (ezetimibe) and a statin (simvastatin), and can decrease total and LDL cholesterol and raise HDL levels.
In some cases, patients may be prescribed more than one cholesterol-lowering drug to achieve the desired results.
What Are the Side Effects of Cholesterol-Lowering Drugs?
The side effects of cholesterol-lowering drugs include:
Are There Foods or Other Drugs I Should Avoid While Taking Cholesterol-Lowering Drugs?
Ask your doctor about the other drugs you are taking, including herbals and vitamins, and their impact on cholesterol-lowering drugs. You should not drink grapefruit juice while taking cholesterol-lowering drugs, as it can interfere with the liver's ability to metabolize these medications.
How to Lower Your Cholesterol
Cholesterol is a waxy, fat like substance that your body needs to function normally. Cholesterol is naturally present in cell walls or membranes everywhere in the body, including the brain, nerves, muscles, skin, liver, intestines, and heart.
Your body uses cholesterol to produce many hormones, vitamin D, and the bile acids that help to digest fat. It takes only a small amount of cholesterol in the blood to meet these needs. If you have too much cholesterol in your bloodstream, the excess may be deposited in arteries, including the coronary (heart) arteries, where it contributes to the narrowing and blockages that cause the signs and symptoms of heart disease. Normally all of the colesterol the body need made on liver, but cholesterol also enter to body from food, such as animal-based foods likes milk, eggs, meat. Too much cholesterol in your body is a major risk factor for heart disease.
How Does High Cholesterol Cause Heart Disease?
When there is too much cholesterol in your blood, it builds up in the walls of your arteries, causing a process called atherosclerosis, a form of heart disease. The arteries become narrowed and blood flow to the heart muscle is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.
There are two forms of cholesterol:
1. Low-density lipoprotein (LDL or "bad" cholesterol)
- LDLs have litle protein and high levels of cholesterol
- LDL is the main source of artery clogging plaque
- HDLs have high level protein and very litle cholesterol
- HDL actually works to clear cholesterol from the blood
What Are the Symptoms of High Cholesterol?
High cholesterol itself does not cause any symptoms; so many people are unaware that their cholesterol levels are too high. Therefore, it is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it.
What Numbers Should I Look For?
Some recommend that everyone over the age of 20 should get their cholesterol levels measured at least once every 5 years. The test that is performed is a blood test called a lipoprotein profile. That includes:
- Total cholesterol level
- LDL (the "bad" cholesterol)
- HDL (the "good" cholesterol)
- Triglycerides
*/ HDL (good) cholesterol protects against heart disease, so higher HDL number is better
What Affects Cholesterol Levels?
A variety of factors can affect your cholesterol levels. They include:
- Diet. Saturated fat, trans fat, and cholesterol in the food you eat increase cholesterol levels. Reducing the amount of saturated fat and trans fats and cholesterol in your diet helps lower your blood cholesterol level. Increasing the amount of fiber and plant derived sterols can also help lower LDL cholesterol.
- Weight. In addition to being a risk factor for heart disease, being overweight can also increase your cholesterol. Losing weight can help lower your LDL, total cholesterol levels, and triglyceride levels, as well as raise your HDL.
- Exercise. Regular exercise can lower LDL cholesterol and raise HDL cholesterol. You should try to be physically active for 30 minutes on most days.
- Age and Gender. As we get older, cholesterol levels rise. Before menopause, women tend to have lower total cholesterol levels than men of the same age. After menopause, however, women's LDL levels tend to rise.
- Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
- Medical conditions. Occasionally a medical condition may cause an elevation of cholesterol levels in the blood. These include hypothyroidism (an underactive thyroid gland), liver disease and kidney disease.
- Medications. Some medicines, like steroids and progestins may increase the "bad" cholesterol and decrease the "good" cholesterol.
The main goal in treating high cholesterol is to lower your LDL. To lower cholesterol, eat a heart-healthy diet, exercise regularly, and maintain a healthy weight. Some may also need to take cholesterol lowering drugs.
Doctors determine your "goals" for lowering LDL based on the number of risk factors you have for heart disease.
Major risk factors include: age (men 45 years and older, women 55 years and older), cigarette smoking, high blood pressure, an HDL less than 40 mg/dL, family history of premature heart disease in a male first degree relative less than 55 years and female first degree relative less than 65 years of age.
- If you have 0-1 risk factor for heart disease, you are at low-to-moderate risk. Generally, lifestyle changes are effective in keeping the cholesterol in check.
- If you have 2 or more risk factors for heart disease, you are at moderate risk, depending on what heart disease risk factors you have. Sometimes your doctor will try lifestyle changes, but most people require cholesterol-lowering drugs or drugs to raise HDL plus an appropriate diet and exercise program.
- If you have known heart disease, diabetes, or multiple risk factors, you are at high risk. Most people in this group will require a combination of cholesterol-lowering drugs and lifestyle changes to control their cholesterol levels.
- Category I, Highest Risk (ten-year risk greater than 20%*): your LDL goal is less than 100 mg/dL. For those with a very high risk (those who have had a recent heart attack, those with cardiovascular disease or peripheral artery disease combined with diabetes or poorly controlled risk factors, or those with metabolic syndrome), it may be most effective for the LDL goal to be less than 70 mg/dL.
- Category II, Next Highest Risk (ten-year risk 10-20%*): your LDL goal is less than 130 mg/dL. Your doctor may set your LDL goal at less than 100 mg/dl if your LDL is 100-129.
- Category III, Moderate Risk (ten-year risk less than 10%*): your LDL goal is less than 130 mg/dL. Your doctor may set your LDL goal at less than 100 mg/dl if your LDL is 100-129.
- Category IV, Low Risk (0-1 risk factor*): your LDL goal is less than 160 mg/dL.
- Risk categories are based on the Framingham Heart Study to estimate 10-year risk for coronary heart disease (heart attack and coronary death). It is based on adults aged 20 and older who do not have heart disease or diabetes. The risk factors included in the Framingham calculation are age, total cholesterol, HDL cholesterol, systolic blood pressure, treatment for high blood pressure, and cigarette smoking.
- Control any other risk factors you may have, such as high blood pressure and smoking.
- Follow a low saturated fat, low cholesterol eating plan
- Maintain a desirable weight.
- Participate in regular physical activity.
- Begin medication therapy as directed by your physician.
Cholesterol-lowering drugs include:
- Statins
- Niacin
- Bile-acid resins
- Fibric acid derivatives
- Selective cholesterol absorption inhibitors
Statins
Statins block the production of cholesterol in the liver itself. They lower LDL, the "bad" cholesterol, and triglycerides and have a mild effect in raising HDL, the "good" cholesterol. These drugs are the first line of treatment for most people with high cholesterol. Side effects can include intestinal problems, liver damage, and in a few people, muscle tenderness or weakness.
Examples of statins include:
- Altocor
- Crestor
- Lipitor (atorvastatin)
- Lescol (Fluvastatin)
- Mevacor (lovastatin)
- Pravachol (pravastatin)
- Zocor (simvastatin)
Caduet is a new drug that is a combination of a statin (Lipitor or atorvastatin) and a blood pressure-lowering drug called amlodipine (Norvasc). Vytorin is a combination of a statin and a cholesterol absorption inhibitor((simvastatin + ezetimibe).
Niacin
Niacin is a B-complex vitamin. It's found in food, but is also available at high doses by prescription. It lowers LDL cholesterol and raises HDL cholesterol. These drugs also lower elevated triglycerides. The main side effects are flushing, itching, tingling, and headache, yet aspirin can reduce many of these symptoms. However, speak with your doctor first. Niacin or nicotinic acid, includes the brand names Niacor, Niaspan, or Slo-niacin. Over-the-counter preparations include extended-release, timed-release, and controlled-release. Niacin found in dietary supplements should not be used to lower cholesterol. Your doctor or lipid specialist will let you know what type of niacin is best for you.
Bile Acid Sequestrants
These drugs work inside the intestine, where they bind to bile and prevent it from being reabsorbed into the circulatory system. Bile is made largely from cholesterol, so these drugs work by reducing the body's supply of cholesterol, thus lowering total and LDL cholesterol. The most common side effects are constipation, gas, and upset stomach. Examples of bile acid resins include:
- Questran and Questran Light (cholestyramine)
- Colestid (colestipol)
- WelChol (colesevelam)
Fibrates lower triglyceride levels and can increase HDL and lower LDL cholesterol. The mechanism of action is not clear but it is thought that fibrates enhance the breakdown of triglyceride-rich particles and decrease the secretion of certain lipoproteins. In addition, they induce the synthesis of HDL.
Examples of fibrates include:
- Tricor (fenofibrate)
- Lopid (gemfibrozil)
- Lofibra (fenofibrate)
Zetia (ezetimibe) works to lower LDL by inhibiting the absorption of cholesterol in the intestines. Vytorin is a newer drug that is a combination of Zetia (ezetimibe) and a statin (simvastatin), and can decrease total and LDL cholesterol and raise HDL levels.
In some cases, patients may be prescribed more than one cholesterol-lowering drug to achieve the desired results.
What Are the Side Effects of Cholesterol-Lowering Drugs?
The side effects of cholesterol-lowering drugs include:
- Muscle aches*
- Abnormal liver function
- Allergic reaction (skin rashes)
- Heartburn
- Dizziness
- Abdominal pain
- Constipation
- Decreased sexual desire
- Memory problems
Are There Foods or Other Drugs I Should Avoid While Taking Cholesterol-Lowering Drugs?
Ask your doctor about the other drugs you are taking, including herbals and vitamins, and their impact on cholesterol-lowering drugs. You should not drink grapefruit juice while taking cholesterol-lowering drugs, as it can interfere with the liver's ability to metabolize these medications.
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