High cholesterol levels may require more than lifestyle and habit changes for some people to bring them down to a level in the typical healthy range. For these people, medications can play a helpful role in reducing their risk of heart attack and stroke.
Cholesterol medication can help lower a person’s cholesterol levels when lifestyle changes have not been successful. In doing so, these medications can help to reduce a person’s risk of having a heart attack, stroke, or other health complications due to high cholesterol.
This article reviews when a person may need to take cholesterol medication and the types of medications that are available.
Not everyone with elevated cholesterol levels
Doctors may start treatment by suggesting lifestyle changes, which can include changes to diet, exercise and activity levels, weight, and smoking cessation. If these changes are enough to lower levels, a person likely will not need medication.
However, a doctor will typically assess a person’s risk factors for cardiovascular events, such as heart attack and stroke.
People with additional risk factors may find that their doctor prescribes them cholesterol medication as a first-line treatment. Some risk factors
- high blood pressure
- previous heart attack or stroke
- being a smoker
- family history
- having diabetes
Based on these risk factors, a doctor will likely prescribe cholesterol medication if the person:
- had a previous heart attack or stroke
- has peripheral arterial disease
- is 40 to 75 years old with a high risk of developing heart disease or stroke and also has an LDL cholesterol level of 70 mg/dL or higher
- has an LDL cholesterol level of 190 mg/dL or higher
- is aged 40 to 75 and living with diabetes, alongside having an LDL cholesterol level of 70 mg/dL or higher
Lifestyle changes, such as diet and exercise,
According to the
For some, these factors may outweigh any changes to diet, exercise, smoking status, or weight a person may make as part of their treatment plan.
If a person cannot lower their cholesterol with lifestyle changes, their doctor will likely recommend medications to help lower their cholesterol levels. Some available medications are described below.
Statins work by slowing the liver’s production of cholesterol. They can also help to reduce the amount of LDL cholesterol already circulating in the blood. They are a prescription medication that comes in pill or tablet form.
A person should also check with their doctor before taking statins to make sure they will not interact with their other medication or supplements.
A person’s doctor may advise the use of different medications or switching the other medications.
Bile acid sequestrants
They are one of the oldest available medications for cholesterol control and are typically less effective than other forms of medication.
A doctor may prescribe one of three types of bile acid sequestrants in the United States. They come in pill or tablet form. Available bile acid sequestrants include colesevelam (Welchol) and colestipol (Colestid).
The biggest risk involved in taking bile acid sequestrants is potential interactions with other medications, supplements, and hormones.
Bile acid sequestrants can prevent the absorption of these medications or supplements, which can lead to ineffective levels in the body.
Fibrates lower a person’s triglyceride levels.
Triglycerides are the most common form of fat in the body. They help store the excess energy a person intakes through their diet. Together with LDL cholesterol, they
A doctor can prescribe one of three different types of fibrates,
- gemfibrozil (Lopid)
- clofibrate (Atromid-S)
- fenofibrate (Antara, Lofibra, Tricor, and Triglide)
Though generally well tolerated, fibrates can cause some side effects and adverse reactions. Some possible side effects
- leg or abdominal cramping
- deranged AST and ALT levels (due to interaction in the liver)
- not generally recommended for use with statins
Niacin comes as both a prescription and over-the-counter (OTC) supplement. The
Side effects can include:
- liver damage
- upset stomach
A newer form of treatment comes as an injectable medication that people know as PCSK9 inhibitors. PCSK9 inhibitors work by binding to a protein found on cells in the liver that produce LDL cholesterol.
Ezetimibe is the
A person should discuss their outlook with their doctor.
If a medication helps to reduce cholesterol levels to a typical level, it
However, many people will need to continue to take one form of medication or another for the rest of their lives to help them control their cholesterol levels. They will also likely need to continue lifestyle changes to help manage their cholesterol levels.
Not all people with high cholesterol will need medications. They may be able to control it with diet, exercise, and other lifestyle changes.
However, people with additional risk factors for heart disease or who cannot lower their cholesterol levels with lifestyle changes will likely need medication to help control their cholesterol levels and reduce their risk of cardiovascular events.