cholesterol treatment guide

Cholesterol Treatment Guide

How Is High Cholesterol Treated?


Medical treatment for high cholesterol (hypercholesterolemia) typically varies according to cholesterol count, age of patient, the presence of secondary disease (eg. atherosclerosis), and the presence of additional risk factors such as family history (eg. familial hypercholesterolemia or family cardiovascular disease). In general, treatment with cholesterol-lowering drugs is required when there is established cardiovascular disease and total serum cholesterol remains greater than 200 mg/dL (UK: about 5mmol/l). Cholesterol reducing meds may also be needed when lifestyle improvements fails to lower a high cardiovascular risk in someone without disease. In any event, anyone with raised cholesterol – 200–239 mg/dL (UK, 5.2 to 7.8mmol/l) should discuss their levels with their doctor.

What Are Healthy Cholesterol Levels

Medical research continues to explore what constitutes a healthy cholesterol count. One issue is the fact that several clinical trials have demonstrated that “normal” cholesterol values are not necessarily synonymous with “healthy” cholesterol values. Nevertheless, in this article we follow the current guidelines, as follows:

Healthy Cholesterol Count

– Desirable: Less than 200 mg/dL (UK: less than 5mmol/l)
– Borderline High Risk: 200–239 mg/dL (UK: 5 to 7.8mmol/l)
– High Risk: 240 mg/dL and over (UK: above 7.8mmol/l)

Types Of Treatment For Raised Cholesterol

As stated above, treatments vary according to patient condition, age and history. For example, patients with moderate hypercholesterolemia aged 50 years or older, who have no other risk factors, are often not treated at all. This is because people in this age group have no increased overall mortality with either high or low serum cholesterol levels. On the other hand, patients with familial hypercholesterolemia or familial combined hyperlipidemia are always treated with medication, as it is difficult for them to normalise their cholesterol levels by lifestyle changes alone.

Most Treatment Combines Lifestyle Changes And Drugs

Regular treatment for hypercholesterolemia usually involves a program which combines lifestyle changes with cholesterol lowering medications, according to the patient’s measurements of LDL, HDL and triglycerides.

Treating Cholesterol With Medications

Many physicians and heart specialists will initially prescribe medication in combination with diet and exercise. Statins are the most commonly used and effective forms of medication for the treatment of high cholesterol. Examples of cholesterol lowering statins include: Crestor (rosuvastatin), Inegy (Simvastatin, ezetimibe), Lescol XL (fluvastatin), Lipitor (atorvastatin), Lipostat (pravastatin), Zocor (simvastatin).

Treating Cholesterol With Lifestyle Changes

In order to reduce cholesterol and other blood fats with lifestyle changes, doctors normally recommend the following:

A Cholesterol Lowering Diet

– Low in trans fats (eg. from cakes, cookies, crackers, pies)
– Low in saturated fat (eg. from animal foods and eggs)
– With moderate amounts of essential fatty acids (eg. from flaxseed oil, oily fish)
– Rich in fresh fruits and vegetables
– Rich in high fiber, low-GI carbohydrates

Note that such a dietary regimen differs from the traditional “low-fat” diet which understated the health risks of trans fats and ignored the benefits of certain fats (eg. omega 3). Note also the need to confine carb intake to high-fiber whole grain carbs with a low-GI value. Refined carbs may increase triglycerides, lower HDL (good) cholesterol, and may cause a deterioration in LDL.

Increased Physical Exercise

Regular physical workouts help to lower LDL and raise HDL cholesterol. Exercise also assists weight management. Vigorous physical exercise helps to break up blood clots. Cardiologists and heart surgeons invariably stress the importance of exercise for post-operative recovery. Even 20 minutes of exercise three times a week, (eg. walking or biking) helps to significantly lower a raised cholesterol level and thus reduce cardiovascular risk. However, before undertaking any fitness program to reduce cholesterol, patients should seek medical advice from their physician.

Weight Reduction

Obesity (BMI > 30), especially morbid obesity (BMI > 40) is associated with a range of metabolic and cardiovascular disorders. Even mild obesity can be dangerous when fat is located around the stomach or abdomen. Thus patients with hypercholesterolemia who are obese are always advised to lose weight to reduce the risk of lipid-related disease. Reducing weight typically lowers LDL and total cholesterol, raises HDL and lowers triglycerides.

Quit Smoking

Tobacco abuse interferes with the body’s ability to regulate lipid levels, including cholesterol, and is a major independent risk factor for heart attacks and strokes. Patients with hypercholesterolemia are always advised to quit smoking.

Drink In Moderation

While clinical trials show that a modest alcohol intake may have a protective effect against cardiovascular disease, heavy drinking has an adverse health effect on the liver and cholesterol levels. Patients with hypercholesterolemia are always advised to normalize their alcohol consumption.