Understanding Cholesterol: Diagnosis and Treatment
What Are the Treatments for Cholesterol Problems? continued...
Garlic is a food item that has been shown in studies to reduce LDL cholesterol, but not other forms of cholesterol. Talk to your health care provider before using garlic or garlic supplements to lower cholesterol.
Cholesterol-lowering products. If your cholesterol is only mildly elevated, your doctor may suggest that you substitute cholesterol-lowering margarines, such Benecol and Take Control, into your diet.
Exercise. Studies show that regular exercise improves cholesterol levels.
Medical Treatments. Drug treatment for high cholesterol centers on reducing the LDL level, and the degree of LDL lowering depends on a person's risk category (based on the LDL value and a person's risk of having a heart attack within the next 10 years). These risk factors include being older than age 45 for men and age 55 for women (unless you're a woman who has gone through premature menopause), high blood pressure, diabetes, smoking, obesity, sedentary lifestyle, and a family history of cardiovascular disease.
Statin drugs are among the most widely used medicines for lowering total and LDL cholesterol. Studies have shown that they also help reduce the risk of future cardiac events. Statins available in the U.S. are: Mevacor, Altocor, Pravachol, Lescol, Zocor, Crestor, and Lipitor. These drugs work by blocking the liver's ability to produce cholesterol. Though they usually don't cause problems, in rare instances, they can cause reversible damage to the liver and muscle. Because of this, your doctor will periodically perform blood tests to check your liver function.
Statins also carry warnings that memory loss, mental confusion, high blood sugar, and type 2 diabetes are possible side effects. It's important to remember that statins may also interact with other medications you take.
Niacin is an alternative for some people, but to be effective it must be taken in large doses. Unfortunately, in these amounts it often causes skin flushing and upset stomach. Newer versions of niacin made to minimize these side effects may be better tolerated. Despite its effects on cholesterol levels, an important scientific study recently found that adding niacin to statin therapy did not reduce the risk of future cardiac events.
A group of drugs called bile acid binders (cholestyramine and colestipol) may also lower total and LDL cholesterol in some people by depleting the supply of LDL cholesterol. But these drugs also have side effects -- namely bloating, gas, and constipation.
Another group of drugs called fibric acid derivatives are occasionally used to increase HDL cholesterol and lower triglyceride levels. They also mildly lower LDL.
Zetia (ezetimibe) is a drug that directly blocks the absorption of cholesterol in the small intestine. Usually it is used in combination with a statin -- getting up to an additional 25% reduction of cholesterol. Zetia is also controversial, however, because of a lack of evidence that it decreases the risk of heart attack or death from heart disease.