: How can I get my LDL or bad cholesterol under control?
Jonathan Sackner Bernstein, MD: Well the first step that is recommended in any of the standard guidelines is lifestyle modifications, so that focuses on changing your diet, losing weight, exercising,
and studies have shown that those approaches can have an effect if you're someone who can really adhere to that type of program, that type of lifestyle, which is not easy for most of us.
But the amount of the effect is relatively modest, and so it is not surprising that doctors tend to go to the next step relatively frequently, which is the prescription of medicines such as statins.
so these are medicines such as Lipitor, Zocor, Pravachol, Crestor. These are medicines that have been used by millions of people. They are not brand new medicines.
The first one, Mevacor, is, was discovered back in the 80s and came out in the early 90s. There have been studies with thousands of people followed for several years.
Huge databases of people followed since these drugs were on the market.
So that we know, that not only do these drugs lower your LDL cholesterol,
but for most of them, there have been studies that have shown that they also reduce your risk of a heart attack, stroke and dying early.
Now you can find out that there have been side effects with these medicines as there are with any medicines, that's why they are taken under the supervision of a doctor.
But if you look on balance with the amount of benefit you can get verses those potential risks which are very, very rare, that overall, for almost all of us who have high cholesterol,
the risk benefit balance when you look at what you should do says that it's safer to take the medicine than to not take the medicine if your LDL cholesterol,
your bad cholesterol remains high after all attempts at lifestyle modification.