Treatment for High Cholesterol

Lifestyle Changes

Eat a heart healthy diet:

• Avoid food products from animals— including meats, poultry, shellfish, eggs, butter, cheese and whole or 2 percent milk.  Watch for other food that can also contain saturated fats and trans fats.  Both margarine and butter are high in fat, so use both in moderation.
• Keep your intake of total fat to between 25 percent and 35 percent of your daily calories.
• Keep your saturated fat intake to less than 7 percent of your daily calories.
• Keep your intake of trans fat to less than 1 percent of your total daily calories.
• Limit your intake of cholesterol from food to less than 300 mg per day. Your health care practitioner will help determine the amount of cholesterol you should consume on a daily basis.
• Eat at least 25 to 30 grams of dietary fiber each day — preferably from whole grains, fruits, vegetables and legumes.
• If you drink alcohol, do so in moderation (no more than one drink a day for women, no more than two for men).
• Eat a diet rich in vegetables, fruits, whole grains, high-fiber foods, lean meats and poultry, fish (such as salmon, trout or haddock) at least twice a week, and fat-free or 1 percent fat dairy products.

Exercise

A daily 30 minute walk at a brisk pace, aerobics, jogging or swimming can help: 

• Raise HDL's (the good cholesterol)
• Lower triglycerides
• Lower blood pressure
• Improve blood sugar
• Lower stress
• May help you lose weight
• Cardiac Rehabilitation

Even mild activities, if done daily, can help.  You can benefit from simple things like walking, gardening, housework or dancing.  Talk to your doctor about getting started, especially if you have been inactive.

Quit smoking

Smoking has been shown to lower HDL (good) cholesterol levels.  Exposure to other people's smoke increases the risk of heart disease even for nonsmokers.  Smoking also decreases your tolerance for physical activity, making it harder to get the activity you need to help you reach healthy cholesterol levels.

Communicate with your doctor

Your health is your responsibility.  Ask your doctor if your cholesterol needs to be tested.  Learn how to interpret all the numbers, including HDL (good) cholesterol, LDL (bad) cholesterol and triglyceride levels.  If you are in a high or borderline-high range, discuss options with your physician.

Take your medications

Drug therapy is usually prescribed for those who, despite adequate dietary changes, regular physical activity and weight loss, still have elevated levels of cholesterol, or for those who have elevated risks for heart disease and stroke.  Modern medications have come a long way in helping to control blood cholesterol levels, and some can target the cholesterol that your body makes on its own.  Making diet and lifestyle changes, as well as taking the medication your doctor prescribes, is the best way to help prevent heart disease.  It is also very important to take your medication exactly as your doctor has instructed so it can efficiently work.  Do not stop taking your medications or skip a dose without checking with your doctor.

Children and cholesterol

Children with one parent that has a total cholesterol greater than 240 mg/dL  are at risk for heart and blood vessel disease.  Children should be monitored and steps taken to reduce their risk factors:

• Have the child's cholesterol level checked
• Dietary habits may need to be adjusted
• Cigarette smoking should be discouraged
• Regular aerobic exercise should be encouraged
• High blood pressure should be identified and treated
• Overweight should be avoided or reduced
• Diabetes mellitus should be diagnosed and treated

Cholesterol-Lowering Drugs

For some people, lifestyle changes alone are not enough to reach healthy cholesterol levels.  Your doctor may prescribe one or more medication(s) that can lower blood cholesterol levels.  Be sure to tell your doctor about all other prescription and over-the-counter medicines you are taking.  It is important to continue taking your medicines unless your doctor tells you to stop.

Statins (also known as HMG CoA reductase inhibitors)

This class of drugs works in the liver to prevent the formation of cholesterol. Statins are most effective at lowering the LDL (bad) cholesterol, but also have modest effects on lowering triglycerides (blood fats) and raising HDL (good) cholesterol.

Selective cholesterol absorption inhibitors

This relatively new class of cholesterol-lowering medications works by preventing the absorption of cholesterol from the intestine. Selective cholesterol absorption inhibitors are most effective at lowering the LDL (bad) cholesterol, but may also have modest effects on lowering triglycerides (blood fats) and raising HDL (good) cholesterol.

Resins (also known as bile acid sequestrant or bile acid-binding drugs)

This class of LDL-lowering drugs works in the intestines by promoting increased disposal of cholesterol. Your body uses cholesterol to make bile, an acid used in the digestive process. These medicines bind to bile, so it cannot be used during digestion. Your liver responds by making more bile. The more bile your liver makes, the more cholesterol it uses. That means less cholesterol is left to circulate through your bloodstream.

Fibrates (fibric acid derivatives)

Fibrates are best at lowering triglycerides and in some cases increasing HDL (good cholesterol) levels. These drugs are not very effective in lowering LDL (bad) cholesterol. This is the reason why fibrates are generally used in people whose triglycerides are high or whose HDL is low, after reaching their LDL goal.

Niacin (nicotinic acid)

This drug works in the liver by affecting the production of blood fats.  Niacin is prescribed to lower triglycerides and LDL cholesterol and raise HDL ("good") cholesterol.  Niacin comes in a prescription form and as “dietary supplements.” Dietary supplement niacin must not be used as a substitute for prescription niacin. It should not be used for lowering cholesterol because of potential very serious side effects. Consult your doctor before starting any niacin therapy.

 For more information:

You can contact one of the following national organizations for more information:

American Heart Association National Center
7272 Greenville Avenue
Dallas, TX75231-4596
Phone: 1-800-242-8721
Web Address: American Heart

American Red Cross National Headquarters
2025 E Street NW
Washington, DC20006
Phone: 1-202-303-4498
Web Address: Red Cross

National Heart, Lung and Blood Institute
Health Information Center
P.O. Box 30105
Bethesda, MD20824-0105
Phone: 1-301-592-8573
Web Address: National Heart, Lung and Blood Institute