What Is the Treatment for High Cholesterol?
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Cholesterol is a waxy substance in the body that works to help support cell membranes, aid in digestion, convert vitamin D in the skin, and manufacture hormones. About 75% of cholesterol in the body is naturally produced in the liver and the rest comes from the foods we eat.
The American Heart Association recommends adults 20 years and older have cholesterol levels checked every four to six years.
Cholesterol scores usually include three measurements:
- Low density lipoproteins (LDL)
- “Bad” cholesterol
- This is the type of cholesterol that needs to be reduced
- Excess LDL can build up in artery walls and form plaque that narrows arteries and restricts blood flow, which can lead to coronary artery disease
- High LDL cholesterol increases the risk of stroke and heart attack
- High density lipoproteins (HDL)
- “Good” cholesterol
- HDL removes LDL cholesterol from the bloodstream and artery walls
- A higher HDL score is desirable
- Triglycerides
- The most common form of fat in the body
- A high triglyceride level can mean a higher risk for coronary artery disease
Treatment to bring cholesterol down quickly starts with the following lifestyle changes:
- Eat a heart-healthy diet
- The American Heart Association recommends limiting saturated fat in the diet to less than 6% of daily calories and minimizing consumption of trans fats
- Consume more plant sources of protein such as beans, lentils, and tofu
- Pay attention to fat intake (All types of fat are calorie-dense and can lead to being overweight)
- Avoid saturated fats and trans fats
- Avoid dietary sources of cholesterol such as egg yolks, organ meats, and shellfish
- Limit so-called “good” fats such as omega-3s and olive oil
- The DASH (Dietary Approaches to Stop Hypertension) eating plan promoted by the National Heart, Lung, and Blood Institute is considered a heart-healthy approach
- Eat fewer refined grains, such as white bread, white rice, white pasta, and white-flour foods like muffins, croissants, bagels, crackers, dried cereals, pretzels, and chips
- Choose whole grains such as wild rice, quinoa, whole-wheat couscous, polenta (cornmeal), and kasha
- Lose weight if you are overweight
- Exercise regularly
- Don’t smoke or vape
If lifestyle changes don’t work to sufficiently lower cholesterol, medications used to treat high cholesterol include:
- PCSK9 inhibitors to lower LDL (bad) cholesterol
- Alirocumab (Praluent)
- Evolocumab (Repatha)
- Statins (HMG CoA reductase inhibitors)
- Atorvastatin (Lipitor)
- Fluvastatin (Lescol)
- Lovastatin (Mevacor, Altoprev)
- Pravastatin (Pravachol)
- Rosuvastatin calcium (Crestor)
- Simvastatin (Zocor)
- Ezetimibe (cholesterol absorption inhibitors)
- Bile acid sequestrants (also called bile acid-binding agents)
- Adenosine triphosphate-citrate lyase (ACL) inhibitors
- Bempedoic acid (Nexletol)
- Bempedoic acid and ezetimibe (Nexlizet)
- Fibrates
- Clofibrate (Atromid-S)
- Fenofibrate (Antara, Lofibra, Tricor, and Triglide)
- Gemfibrozil (Lopid)
- Niacin (nicotinic acid), a B vitamin
- Omega-3 fatty acid ethyl esters
- Epanova
- Lovaza
- Omtryg
- Vascepa
- Marine-derived omega-3 polyunsaturated fatty acids (PUFA)
What Are Normal Cholesterol Levels?
People who do not have heart disease should aim for the following cholesterol levels, which are considered normal:
Total cholesterol below 200 mg/dL |
LDL cholesterol below 130 mg/dL |
HDL cholesterol above 60 mg/dL |
Triglycerides below 150 mg/dL |
Non-HDL cholesterol below 160 mg/dL |
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Cholesterol Resources
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https://www.heart.org/
https://www.uptodate.com/contents/high-cholesterol-the-basics?search=cholesterol&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/
https://www.pritikin.com/your-health/health-benefits/lower-cholesterol/1759-5-tactics-to-reduce-cholesterol-quickly.html
https://www.pritikin.com/your-health/health-benefits/lower-cholesterol/1759-5-tactics-to-reduce-cholesterol-quickly.html