My Cholesterol Guide Do you Cholssterol questions about cholesterol? home Cholesterol Home. adults have confirmed or probable FH. Plaque can cause an artery to become narrowed or blocked.

Minimizing high cholesterol risks -

It can also help protect their arteries. Nonsmokers should avoid exposure to secondhand smoke. Learn more about quitting smoking. Being overweight or obese tends to raise bad cholesterol and lower good cholesterol. Your health care professional can help you reach your health goals, including keeping your cholesterol at healthy levels.

Written by American Heart Association editorial staff and reviewed by science and medicine advisors. See our editorial policies and staff.

About Cholesterol. HDL, LDL Cholesterol and Triglycerides. Genetic Conditions. Causes of High Cholesterol. How To Get Your Cholesterol Tested.

Prevention and Treatment of High Cholesterol. Cholesterol Tools and Resources. Do you have questions about cholesterol? We have answers. Our FREE cholesterol guide will help you understand and manage your cholesterol, so you can take action and live healthy!

Home Health Topics Cholesterol Prevention and Treatment of High Cholesterol. Play without Auto-Play Play Video Text. Know your numbers. And what to do about them. You can help lower your lipid levels with lifestyle changes, medications, or a combination of both.

In certain cases, a health care provider will recommend a trial of lifestyle changes before recommending a medication. The best approach for you will depend on your individual situation, including your lipid levels, health conditions, risk factors, medications, and lifestyle.

Lifestyle changes — If you have high low-density lipoprotein LDL cholesterol, you should try to make some changes in your day-to-day habits, including reducing the amount of total and saturated fat in your diet, losing weight if you are overweight or obese , getting regular aerobic exercise, and eating plenty of fruits and vegetables see "Patient education: Exercise Beyond the Basics " and "Patient education: Diet and health Beyond the Basics ".

A plant-based diet is an effective strategy to lowering LDL cholesterol. The benefits of these lifestyle changes usually become evident within 6 to 12 months. However, the success of lipid lowering with lifestyle modification varies widely, and health care providers sometimes recommend beginning medication sooner.

Medications — There are many medications available to help lower elevated levels of LDL cholesterol. Each category of medication varies in how it works, how effective it is, and how much it costs.

Your health care provider will recommend a medication or combination of medications based on your blood lipid levels and other individual factors.

Statins — Statins are one of the best-studied classes of medications and the most commonly used drugs for lowering LDL cholesterol. They are the most effective drugs for prevention of coronary heart disease, heart attack, stroke, and death.

Available statins include atorvastatin former brand name: Lipitor , rosuvastatin former brand name: Crestor , and several other similar medications table 1.

Statins decrease the body's production of cholesterol and increase removal of cholesterol by the liver, so they reduce LDL cholesterol levels by as much as 25 to 55 percent.

In addition, they can lower triglycerides. Statins may also reduce inflammation and may prevent heart attacks and strokes through this mechanism.

While most people tolerate statins well, there are some potential side effects, mainly muscle pain, aches, or weakness. Use of statins may also increase the risk of developing diabetes, although the risk is seen mostly in those with prediabetes, and the benefit in reduction on heart attack and stroke is about four times that of the risk of developing diabetes.

Changing statins and using low doses often can avoid these issues, but if not, non-statin medications can be used to lower LDL cholesterol.

It is important to closely follow the dosing instructions for when to take statins; some are more effective when taken before bedtime while others should be taken with a meal. In addition, some foods, such as grapefruit or grapefruit juice, can increase the risk of side effects of statins.

Most manufacturers recommend that people who take lovastatin, simvastatin, or atorvastatin consume no more than one-half of a grapefruit or 8 ounces of grapefruit juice per day. Ezetimibe — Ezetimibe brand name: Zetia blocks the body's ability to actively transport cholesterol from food as well as cholesterol that the body produces internally.

It lowers LDL cholesterol levels by 20 to 25 percent and has relatively few side effects. It is usually prescribed in combination with a statin but is also used alone in patients who cannot tolerate a statin.

When used in combination with a statin after an acute coronary syndrome eg, heart attack , ezetimibe provides a small additional reduction in the risk of having another cardiovascular event. PCSK9 inhibitors — PCSK9 monoclonal antibody inhibitors are another class of drugs that lower LDL cholesterol levels sample brand names: Praluent, Repatha table 1 ; they are given by injection under the skin every two to four weeks.

They reduce cardiovascular events such as heart attack or stroke and potentially death. Aside from mild skin reactions at the site of injection, they have few side effects.

Inclisiran brand name Leqvio is a PCSK9 inhibitor that is given by injection once, 90 days later, and then every six months. However, they are expensive and their use is limited to patients treated with maximal tolerated statins who have persistent elevations of LDL cholesterol.

Bile acid sequestrants — The bile acid sequestrants include colesevelam brand name: Welchol , colestipol brand name: Colestid , and cholestyramine sample brand names: Prevalite, Questran table 1.

These medications bind to bile acids in the intestine, reducing the amount of cholesterol the body absorbs from foods. They are used only occasionally. They lower LDL cholesterol only modestly 10 to 15 percent.

Side effects can be bothersome and may include nausea, bloating, cramping, and liver damage. Taking psyllium a fiber supplement, such as Metamucil can sometimes reduce the dose required and the side effects. Bile acid sequestrants can interact with some medications, including as digoxin brand name: Lanoxin and warfarin brand name: Jantoven , and with the absorption of fat-soluble vitamins including vitamins A, D, K, and E.

Taking these medications at different times of day can solve these problems in some cases. Bempedoic acid — Bempedoic acid brand name: Nexletol is the newest lipid-lowering agent, and it is approved for lowering LDL cholesterol.

It works by inhibiting cholesterol synthesis at a step before the HMG-CoA reductase or the enzyme inhibited by statin therapy. Bempedoic acid alone or in combination with a statin or ezetimibe brand name: Nexlizet lowers LDL cholesterol as well as other atherogenic proteins. Bempedoic acid can reduce the risk of cardiovascular events such as heart attacks.

Side effects include an increase in the incidence of gout, gallstones, kidney damage, and small increases in liver enzymes. Early studies reported Achilles tendon rupture as a rare side effect; however, this effect was not seen in a recent large trial.

Omega-3 — Oily fish, such as mackerel, herring, bluefish, sardines, salmon, and anchovies, contain two important fatty acids called docosahexaenoic acid DHA and eicosapentaenoic acid EPA. Eating a diet that includes one to two servings of oily fish per week can lower triglyceride levels and reduce the risk of death from coronary heart disease.

Fish oil supplements, supplements with low-dose mixed fish oils usually approximately 1 gram per day of combined DHA and EPA , had been thought to provide cardiac benefit, but large trials have found no significant benefit.

As such, they are no longer recommended. A second study of a high-dose agent that had both EPA and DHA failed to provide benefit, suggesting that the EPA only preparation at the 4 g dose is important. However, the trials found that omega-3 fatty acid medications increase the risk of atrial fibrillation.

Therefore, a discussion with your cardiologist on the net benefit or harm from taking fish oil supplements including icosapent ethyl is needed before starting this treatment.

Nicotinic acid niacin — Nicotinic acid is a vitamin that is available in immediate-release, sustained-release, and extended-release formulations table 1. Nicotinic acid is rarely used for a high cholesterol. In most situations, ezetimibe or a PCSK9 inhibitor is tried before nicotinic acid. Historically, this agent used to be used to raise HDL cholesterol levels, but that is no longer recommended.

It is sometimes used for patients with high lipoprotein a levels and LDL cholesterol that is refractory to more effective and better-tolerated medications statins, ezetimibe and PCSK9 inhibitors.

Nicotinic acid is associated with many side effects, including flushing when the face or body turns red and becomes warm , itching, nausea, numbness and tingling, and worsening of gout. This medication can also cause liver damage; people who use it require regular blood tests to monitor their liver function.

Red yeast rice — Red yeast rice is a fermented rice product that can lower serum cholesterol. Red yeast rice contains naturally occurring substances called monacolins that act to reduce cholesterol by a mechanism similar to that of statins. Although red yeast rice is effective for lowering total and LDL cholesterol, there is not evidence that it decreases rates of cardiovascular events or that it is safe to take long-term.

Moreover, red yeast rice supplements are not standardized in the United States. Different commercial preparations vary widely in the amount of the active ingredient, and some commercial preparations have been shown to contain potentially toxic substances or lovastatin, a statin medication.

Soy protein — Soy protein contains isoflavones, which mimic the action of estrogen. In older adults, ezetimibe alone was found to reduce cardiovascular events but not stroke.

PCSK9 inhibitors are a newer class of cholesterol-lowering drugs. They work by allowing more LDL receptors to remain in the liver, thus allowing the liver to sweep more LDL cholesterol out of the bloodstream.

There are two PCSK9 inhibitors on the market, evolocumab Repatha and alirocumab Praluent , and both must be taken by injection every few weeks. The clinical benefit of lowering LDL cholesterol in older adults has been a point of contention, because people ages 75 and older are not usually included in large numbers in clinical trials.

Some have even argued that the risks of LDL-lowering treatment may outweigh benefits for older adults compared to younger adults. But the evidence debunks this myth. Meta-analyses and clinical trials indicate that statin use is not associated with increased risk of muscle injury, cognitive impairment, cancer, or hemorrhagic stroke compared with those not using statins, regardless of age.

Likewise, in clinical trials, risk of liver or kidney injury is similar in people taking statins or a placebo, regardless of age. A prospective study evaluating liver safety in very elderly patients found statins to be safe overall in patients ages 80 and older.

Even if one type of statin causes side effects in a person, another statin may not. Statins can raise blood sugars, but this is unlikely to lead to type 2 diabetes in anyone not already at high risk for the condition.

Similarly, ezetimibe use is largely safe, with diarrhea and upper respiratory infections being the most common side effects.

Notably, the safety profile for ezetimibe plus statins is the same as for statins alone, even in older adults. And finally, PCSK9 inhibitors have not been found to increase risk of diabetes, neurocognitive disorders, liver injury, or muscle injury.

The question remains: do the benefits of cholesterol-lowering treatments outweigh the risks for older adults? In a systematic review and meta-analysis published in The Lancet , researchers evaluated the clinical benefit of statin and non-statin cholesterol-lowering therapy for older adults.

They did this by extracting and re-analyzing data from previous studies that had evaluated statin and non-statin cholesterol-lowering treatments.

The analysis included 21, patients ages 75 and older. Of these, The analysis above largely represented older patients with existing cardiovascular disease.

There are ongoing trials that will help evaluate the utility of statins in older patients as a primary prevention for major cardiovascular events. Follow me on Twitter HannaGaggin. Davis Kimaiyo, MD , Contributor. As a service to our readers, Harvard Health Publishing provides access to our library of archived content.

Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Please read the Beta-alanine and muscle power development Minimizkng the end of this page. A higu cholesterol level also Miinimizing "hypercholesterolemia" can significantly increase your risk of developing chest Nutritional support for tissue repair, heart attack, and stroke. Fortunately, a Inflammation and dental health of effective treatment options are available. While total cholesterol has been a primary focus in the past, current guidelines focus on low-density lipoprotein LDL cholesterol. Higher levels of LDL cholesterol are associated with greater risk of heart attack, stroke, need for stenting or coronary bypass surgery, and death. Studies over the past 50 years have shown that lowering LDL cholesterol leads to lower rates of these cardiac events.

Minimizing high cholesterol risks -

If you have high cholesterol, you are twice as likely to develop heart disease. That is why it is important to have your cholesterol levels checked, especially if you have a family history of heart disease. Centers for Disease Control and Prevention: Cholesterol.

National Institutes of Health, National Heart, Lung, and Blood Institute: Cholesterol. This article was contributed by: familydoctor. org editorial staff. This information provides a general overview and may not apply to everyone.

Talk to your family doctor to find out if this information applies to you and to get more information on this subject. Having a healthy heart is vital to your overall health.

Two of the simplest yet most important ways to…. Adopting habits to keep cholesterol low in childhood can help avoid cholesterol-related health problems later in life. Lowering your bad cholesterol can reduce your risk of having a heart attack or stroke. There are many medicines….

Visit The Symptom Checker. Read More. Food Poisoning. Acute Bronchitis. Eustachian Tube Dysfunction. Bursitis of the Hip. High Blood Pressure. RSV Respiratory Syncytial Virus. Home Diseases and Conditions High Cholesterol. Table of Contents. Cholesterol-lowering Medicines.

Lifestyle Changes to Improve Your Cholesterol. Cholesterol Plant Sterols and Stanols. What is cholesterol? Your ideal cholesterol level will depend on your risk for heart disease. Total cholesterol level — less than is best, but it depends on your HDL and LDL levels. LDL cholesterol levels — less than is best, but this depends on your risk for heart disease.

HDL cholesterol levels — 60 or higher reduces your risk for heart disease. What causes high cholesterol? Smoking also causes high cholesterol. It lowers your HDL good cholesterol. How is high cholesterol diagnosed? Risk factors for heart disease include: Cigarette smoking High blood pressure Older age Having an immediate family member parent or sibling who has had heart disease Being overweight or having obesity Inactivity.

Can high cholesterol be prevented or avoided? Depending on your risk factors, your doctor may prescribe medicine and lifestyle changes. Living with high cholesterol. Questions to ask your doctor. Am I at risk for heart disease?

How often should I get my cholesterol tested? What are my cholesterol levels? Are they high? What lifestyle changes do I need to make to help improve my cholesterol levels and heart health?

Do I need cholesterol medicine? What are the side effects of the medicine? Centers for Disease Control and Prevention: Cholesterol National Institutes of Health, National Heart, Lung, and Blood Institute: Cholesterol.

Last Updated: June 20, This article was contributed by: familydoctor. org editorial staff Categories: Family Health , Seniors. Tags: Blood Thinners , cardiovascular , cholesterol , heart disease , Statins , stroke.

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Statins can raise blood sugars, but this is unlikely to lead to type 2 diabetes in anyone not already at high risk for the condition. Similarly, ezetimibe use is largely safe, with diarrhea and upper respiratory infections being the most common side effects.

Notably, the safety profile for ezetimibe plus statins is the same as for statins alone, even in older adults. And finally, PCSK9 inhibitors have not been found to increase risk of diabetes, neurocognitive disorders, liver injury, or muscle injury.

The question remains: do the benefits of cholesterol-lowering treatments outweigh the risks for older adults? In a systematic review and meta-analysis published in The Lancet , researchers evaluated the clinical benefit of statin and non-statin cholesterol-lowering therapy for older adults.

They did this by extracting and re-analyzing data from previous studies that had evaluated statin and non-statin cholesterol-lowering treatments. The analysis included 21, patients ages 75 and older.

Of these, The analysis above largely represented older patients with existing cardiovascular disease. There are ongoing trials that will help evaluate the utility of statins in older patients as a primary prevention for major cardiovascular events.

Follow me on Twitter HannaGaggin. Davis Kimaiyo, MD , Contributor. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Managing Your Cholesterol offers up-to-date information to help you or a loved one keep cholesterol in check.

The report spells out what are healthy and unhealthy cholesterol levels, and offers specific ways to keep cholesterol in line. It covers cholesterol tests and the genetics of cholesterol. The report also focuses on treatments based on the latest scientific evidence, including the pros and cons of statins and other medications, and provides the lowdown on other substances advertised to lower cholesterol.

Managing Your Cholesterol can also help you work with your doctor to individualize your treatment. Thanks for visiting. Don't miss your FREE gift. The Best Diets for Cognitive Fitness , is yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health , plus the latest advances in preventative medicine, diet and exercise , pain relief, blood pressure and cholesterol management, and more.

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PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts. Sign up now and get a FREE copy of the Best Diets for Cognitive Fitness. Stay on top of latest health news from Harvard Medical School. Recent Blog Articles. Flowers, chocolates, organ donation — are you in?

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Beyond the usual suspects for healthy resolutions. About the Author. Davis Kimaiyo, MD , Contributor Davis Kimaiyo, MD, is an Internal Medicine resident at Massachusetts General Hospital.

Schedule a COVID vaccine xholesterol booster appointment: Log riska to myPennMedicine Nutritional support for tissue repair call us 8am to choleserol, Monday through Friday, Waist circumference and cardiovascular health Nutritional support for tissue repair is a fat also called a lipid that your body needs to work properly. Too much bad cholesterol in your blood can increase your chance of getting heart disease, stroke, and other problems. Common medical terms for high blood cholesterol are lipid disorder, hyperlipidemia, or hypercholesterolemia, with the last being the most precise. Cholesterol - high; Lipid disorders; Hyperlipoproteinemia; Hyperlipidemia; Dyslipidemia; Hypercholesterolemia.

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