Cholesterol Management Health Center

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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 and trans 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 the 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 proved to lower the risk of heart attack, stroke, and death in people with a high risk of heart attack or stroke.^2,³

**Statin medicines**
Generic names	Brand names	How they work
atorvastatin, lovastatin, pravastatin, simvastatin, fluvastatin, rosuvastatin	Lipitor, Mevacor, Pravachol, Zocor, Lescol, Crestor	Reduce how much cholesterol your liver makes

Some statins are combined with another medicine.

**Statin combinations**
Generic names	Brand names	How they work
ezetimibe with simvastatin	Vytorin	Lower how much cholesterol your liver makes and affect how your body absorbs cholesterol
atorvastatin with amlodipine	Caduet	Lower how much cholesterol your liver makes and lower blood pressure
niacin with lovastatin	Advicor	Raise good HDL cholesterol and lower bad LDL cholesterol

Your doctor may prescribe other medicines. Some are used with a statin.

**Drugs that may be used with a statin**
Type of drug	Generic names	Brand names	How they work
Bile acid sequestrants	cholestyramine, colestipol, colesevelam	Questran, Colestid, Welchol	Affect how your body removes cholesterol
Fibric acid derivatives	gemfibrozil, fenofibrate	Lopid, Tricor	Lower triglycerides and can raise good HDL cholesterol. LDL may go up slightly.
Nictonic acid	niacin	Niacor, Niaspan, Nicolar	Raise good HDL cholesterol and lower triglycerides and LDL
Cholesterol absorption inhibitors	ezetimibe	Zetia	Lower how much cholesterol your body can absorb

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WebMD Medical Reference from Healthwise

Last Updated: July 11, 2008

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.