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Drugs to Treat Atherosclerosis

For millions of people at risk for atherosclerosis complications, lifestyle changes aren't enough. Fortunately, there are medications that can protect against atherosclerosis. Some can even partially reverse it.

Statins to Lower Bad Cholesterol

Statins are the best medications for lowering "bad" LDL cholesterol. They are also the most widely used cholesterol drugs. Statins cause LDL levels to fall by up to 60%. They also raise levels of HDL or "good" cholesterol. And they can help lower the level of triglycerides.

Taking a statin for a year or longer can even slightly shrink plaques that cause atherosclerosis. This reversal of atherosclerosis surprised many experts who believed it couldn’t be done.

Completely reversing it isn't possible yet. But taking a statin can reduce the risk of complications from atherosclerosis. For this reason, statins are often key to treating atherosclerosis.

 

Fibrates to Reduce Triglycerides

Fibrates are drugs that reduce triglyceride levels. Triglycerides are not cholesterol, but they are fats that contribute to atherosclerosis.

There are two fibrates used in the U.S.:

  • Gemfibrozil
  • Fenofibrate

Fibrates also slightly increase "good" cholesterol also called HDL. 

Niacin to Improve Overall Cholesterol

Nicotinic acid, commonly called niacin, is a vitamin everyone needs in small doses. Taken in large doses, it improves cholesterol by reducing triglycerides and LDL. It also increases HDL.

Many people have uncomfortable skin flushing that prevents them from taking niacin. (Be wary of "no-flush" over-the-counter preparations: Many lack the active form of niacin.) Niacin also can increase blood sugar levels. This is a problem especially for people with diabetes.

Because of its side effects, niacin is much less frequently prescribed than statins or fibrates.

Other Drugs for Atherosclerosis

Zetia (ezetimibe) works by reducing absorption of cholesterol in the intestines. It can lower LDL levels. But it doesn’t work as well as statins. This drug is usually used in addition to a statin to further lower bad cholesterol. There is no evidence, though, that it reduces the risk of heart attacks or strokes.

Bile acid sequestrants (cholestyramine, colestipol, colesevelam) bind to bile acids in the intestines. This leads to a lower bile acid level. You need bile, so when that happens, cholesterol must be used to make more . This lowers blood cholesterol levels.

Plant sterols are taken as supplements in pill form or in foods like margarine. Getting plant sterols every day can reduce cholesterol modestly by about 10%.

Lovaza and Vascepa (both containing omega-3s) are prescription drugs that can be used with diet to lower high levels of triglycerides.

 

Drugs to Reduce High Blood Pressure

Lowering blood pressure lowers the risk of atherosclerosis and its complications. Diet and exercise alone don't usually bring high blood pressure down to the safe range. Most people with high blood pressure will require medications (usually at least two) to do the job.

There are many classes of high blood pressure drugs that work in a variety of ways. The choice of medicine isn't as important as the result: getting blood pressure down. Blood pressure should always be less than 140 over 90. For people with atherosclerosis, the goal may be below 130 over 80.

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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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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