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Cholesterol & Triglycerides Health Center

High Cholesterol Treatment -- What Works?

Safe, effective treatment for high cholesterol isn't hard -- but it can be confusing. Get the facts.
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Weight Loss & Exercise as a High Cholesterol Treatment continued...

As a high cholesterol treatment, physical activity can have a modest effect. Exercise can lower your triglycerides (and bad LDL cholesterol to a lesser extent) and boost your good HDL cholesterol. So you should aim to get some physical activity -- even just a brisk walk -- for 30-60 minutes most days of the week.

But there are limits to what exercise can do. "For most people, exercise by itself wouldn't be an effective therapy to lower cholesterol," says Laurence S. Sperling, MD, director of preventive cardiology at the Emory University School of Medicine, Atlanta, Ga. But it can keep your weight down and reduce other cardiovascular risks.

Medications as High Cholesterol Treatments

If lifestyle changes haven't been enough as a high cholesterol treatment -- or if you're at high risk of cardiovascular problems -- your doctor will likely turn to medications. In most cases, the first drug you will try is a statin.

Statins like Crestor, Lescol, Lipitor, Mevacor, Pravachol, and Zocor work by blocking the effects of an enzyme that helps make cholesterol. They can lower bad LDL cholesterol by an impressive 20-55%. They have a modest effect on triglycerides and give a mild boost to your good cholesterol, too.

But don't assume that taking a statin makes you invulnerable. They won't cancel out a diet of french fries and fondue. "Statins are a complement to dietary changes," says Hutter, "not a replacement for them."

As with any drug, there are side effects. They can cause muscle aches, an increase in liver enzymes, and other issues. But the risks are low and it's important to keep them in perspective.

"On one hand, statins can reduce your risk of death, heart attack, stroke by 30-35%," says Sperling. "On the other, they pose a 1-2% risk of generally mild side effects." The benefits are often worth the small risk, Sperling says.

Although they tend to be overshadowed by statins, other medicines are also important high cholesterol treatments instead of, or in addition to, statins. They include:

  • Bile acid resins like Colestid, Lo-Cholest, Prevalite, Questran, and WelChol. They stick to cholesterol in the intestines and prevent it from being absorbed. They can lower LDL cholesterol by 15-30%.
  • Ezetimibe (Zetia) blocks some of the cholesterol from being absorbed by your body. It can lower LDL levels by 18-25%.
  • Fibric acid like Antara, Atromid, Lopid, and Tricor. They reduce your triglycerides and may give a mild boost to your HDL.
  • Niacin, available as Niacor, Niaspan, and Nicolar. Niacin modestly lowers LDL cholesterol and triglycerides and can raise HDL cholesterol at low doses. LDL levels are usually cut by 5-15%.
  • A combination medicine like ezetimibe with simvastatin (Vytorin) which uses a statin to block production of cholesterol and ezetimibe to prevent cholesterol from being absorbed.

Remember that medicines aren't right for everyone. Since they're often taken for life, you and your doctor need to carefully discuss whether you should use them.

Is This Normal? Get the Facts Fast!

Is Your Cholesterol Level Heart Healthy?
What is your LDL (low-density lipoprotein) level?

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or
Answer:
Desirable
0-199
Borderline
200-239
High
240+

Your level is currently

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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