Cholesterol: What the Numbers Really Mean
Maintaining healthy cholesterol levels is a balancing act: the right approach to diet, exercise, and, at times, medication.
Treating High LDL
There are five groups of cholesterol-lowering drugs, says Schloss. Many people need at least one drug from two different categories for effective treatment. These include:
- Statins: They help prevent the liver from making cholesterol. Drugs include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor).
- Bile Acid-Binding Resins: Working in the intestines, they bind to cholesterol so the body can excrete it. Drugs include cholestyramine (Questran, Prevalite, Lo-Cholest), colestipol (Colestid), and colesevelam (WelChol).
- Niacin: It's not totally clear how therapeutic doses of this form of vitamin B reduce cholesterol, but niacin may work by decreasing production of cholesterol in the liver. Brand names include Niaspan and Advicor, which combines niacin with the statin lovastatin.
- Cholesterol Absorption Inhibitors: In 2002 the FDA approved ezetimibe (Zetia), the first in a new class of drugs that prevents absorption of cholesterol in the small intestines. Vytorin is a single pill that combines Zetia with the statin simvastatin.
- Fibrates: These drugs work to reduce triglycerides and raise HDL. They include gemfibrozil (Lopid) and fenofibrate (Antara, Lofibra, Tricor, Triglide).
Questions to Ask Your Doctor
- What is my total cholesterol level, and what are the levels of my HDL, LDL, and triglycerides?
- Do I have any other risk factors for heart disease?
- What are the three most important things I can do to lower my cholesterol?
- How often should my cholesterol be checked -- and should other family members be concerned about their cholesterol?
- Will my cholesterol treatment interfere with any other medications I am taking?