High Cholesterol
Treatment Overview
The goal in treating high cholesterol is to reduce your chances of having a heart attack or stroke.
Most people need to adjust their lifestyles to eat less saturated fat, be more active, and lose weight if needed. Others also need to take one or more medicines.
No matter what approach you need, your treatment will focus on lowering your "bad" LDL cholesterol.
You may also need to raise your "good" HDL cholesterol at the same time. Although it may seem odd to raise a type of cholesterol, HDL can help remove the LDL from your arteries.
Initial treatment
After your doctor has looked at your cholesterol test, he or she will base your treatment on your cholesterol levels and overall health.
First, you will need some guidance on how to eat. Your doctor may suggest that you follow a cholesterol-lowering diet that cuts back on saturated fat while still allowing good fat such as olive and canola oils.
Increasing your activity is very important. Exercise can raise your HDL and may help you lose weight, if you need to. If you smoke, quitting will also help you raise your HDL. For more information on quitting smoking, see the topic Quitting Tobacco Use.
If you have diabetes, high blood pressure, or coronary artery disease (CAD) or if your cholesterol is very high, you may need to start on medicine right away. This is because your chances of having a heart attack are high, and medicines can reduce this risk.
Use this Interactive Tool: Are You at Risk for a Heart Attack?
This interactive tool will tell you your percentage of risk. After you know this, you can find your risk category for treatment. Your doctor will base your need for medicine on your risk category. After you have checked your risk, you can learn more about your treatment.
If you need medicine, it likely will be a statin. These drugs reduce the body's natural production of cholesterol. They are proven to lower the risk of heart attack, stroke, and death in people who have high cholesterol.8, 9
Statin medicines Brand names* Generic names How they work Lipitor, Mevacor, Pravachol, Zocor, Lescol, Crestor atorvastatin, lovastatin, pravastatin, simvastatin, fluvastatin, rosuvastatin Reduce how much cholesterol your liver makes *Your doctor may prescribe a generic version of the medicine instead of a brand-name version.
Your doctor may prescribe other medicines. Some are used with a statin.
Drugs combined with or used with a statin Brand names Generic names How they work Advicor niacin with lovastatin Raise good HDL cholesterol and lower bad LDL cholesterol Caduet atorvastatin with amlodipine Lower how much cholesterol your liver makes and lower blood pressure Your doctor may prescribe other medicines. Some are used with a statin.
Drugs that may be used with a statin Brand names Generic names How they work Ezetrol ezetimibe Lower the amount of cholesterol your body can absorb Colestid cholestyramine, colestipol Affect how your body removes cholesterol Lopid, Lipidil gemfibrozil, fenofibrate Raise HDL, lower triglycerides Niaspan niacin Affect how the liver makes cholesterol Canadian experts recommend immediate treatment with statins for people who have a high risk of heart attack. The goal is to lower your LDL to 2.0 mmol/L or less as soon as possible.10 You have a very high risk of having a heart attack if you have coronary artery disease and you also have diabetes, acute coronary syndrome, metabolic syndrome, or if you smoke.
Work with your doctor to treat other diseases that you may have, such as high blood pressure and diabetes, and to stop smoking, if you smoke.
Ongoing treatment
As you continue your treatment for high cholesterol, your doctor will check your cholesterol at times, to see how you are doing. If you have been trying lifestyle changes alone, another cholesterol test can show if those changes have helped or if you need to add medicine to your treatment.
If you are taking medicine already, a cholesterol test can show whether you need your dose lowered or increased or whether you need a different drug.
At this time you may also want to ask for help if you are having trouble changing how you eat. Your doctor can refer you to a dietitian to help you plan meals.
Staying physically active is important. Managing your weight and exercising are important because they can help you raise your HDL and lower your LDL levels. Research shows that people who exercise longer have more improvement in their LDL and HDL levels.11
Losing weight can also help lower high blood pressure. For more information, see the topics Fitness and Healthy Weight.
Treatment if the condition gets worse
It is important to follow your doctor's recommendations for making lifestyle changes and taking medicines, if prescribed. If high cholesterol is not treated, it can lead to coronary artery disease, heart attack, and stroke.
What to think about
High cholesterol that is caused by inherited (genetic) lipid disorders usually is treated with medicines.
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| Author: | Douglas Dana Ralph Poore | Last Updated: November 13, 2006 |
| Medical Review: | Caroline S. Rhoads, MD - Internal Medicine Tom Bailey, MD - Family Medicine Neil J. Stone, MD, FACC, FACP - Internal Medicine, Cardiology | |
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