Treating High
Cholesterol
By Carolyn M.
Clancy, M.D.
August 3, 2010
If you’re older
than 45, there’s a good chance that you or
someone you know has high cholesterol. It’s so
common that treating high cholesterol led to 44
million doctor visits in 2006.
High cholesterol
may be widespread, but understanding how to
treat it can be confusing. However, lowering
high cholesterol can prevent heart attacks and
strokes. It could even save your life.
That’s why my
agency, the Agency for Healthcare Research and
Quality (AHRQ), offers a guide called
Treating High Cholesterol. The guide
explains in plain English how this common
medical condition is treated and the pros and
cons of different cholesterol medicines.
Cholesterol is
vital to your body. Your liver makes
cholesterol, which is found in your blood. We
all need some cholesterol, but too much is
harmful. Your diet and family history affect
your cholesterol levels.
There are two
main types of cholesterol--good (HDL) and bad (LDL)
cholesterol. When your cholesterol is too high,
that refers to your bad cholesterol, or your LDL
level. When bad cholesterol builds up and leaves
deposits (called plaque) in the walls of your
arteries, it can limit blood flow and cause a
heart attack or stroke.
A simple blood
test can determine your cholesterol level and
your risk for heart disease. The more risk
factors you have, the higher the chance you have
high cholesterol. Risk factors include:
- Age (being
45 or older for men or 55 or older for
women).
- Family
history of early heart disease.
- Smoking.
- High blood
pressure.
- Low levels
of good (HDL) cholesterol.
- Diabetes or
certain other conditions.
Your doctor can
help you determine your level of risk. The first
step in controlling your cholesterol is a
balanced diet and more exercise. Your doctor or
nurse may recommend a diet that includes fresh
fruits, vegetables, and whole grains, while
limiting foods that are high in fat. However,
even with a good diet and exercise habits, you
may need medicine to lower your cholesterol.
Different kinds
of medicines work in different ways to improve
cholesterol levels. Some block the liver from
making cholesterol, while others decrease the
amount of fat absorbed from food.
Most people start
with a medicine called a statin, which works to
lower bad (LDL) cholesterol. If your bad
cholesterol remains high, your doctor or nurse
may increase your statin dose or add a different
kind of medicine to help you reach healthy
levels.
Our guide
Treating High Cholesterol, based on a
review of more than 100 research studies of
cholesterol medicines, shows that all such
medicines can cause minor side effects. These
side effects include heartburn, upset stomach,
and diarrhea. These problems often go away and
are not usually serious. But you should tell
your doctor if any symptoms do not disappear.
It’s important to
talk with your doctor or nurse about your high
cholesterol. Good topics include:
- Diet
and exercise. Everyone with high
cholesterol should be on a
cholesterol-lowering diet. Exercise helps,
too. Ask if diet and exercise alone can help
meet your cholesterol goals.
-
Medicines. Talk to your doctor
about how and when to take cholesterol
medicines. Once you start taking medicine to
lower cholesterol levels, you will probably
need to continue.
-
Cost. Some medicines are available
as generics, which cost less than brand-name
drugs. Check with your health insurance plan
about the cost. Our guide offers resources
if you need help paying for your medicines
or have other questions.
-
Other steps for a healthy heart.
Lowering high cholesterol is vital. But it’s
also important to control other health
problems, like diabetes and high blood
pressure. Stopping smoking will also help.
AHRQ’s guides can
help make complex decisions--including how to
treat high cholesterol--easier to understand. By
understanding the benefits and risks of
treatments, you can work with your doctor to
make decisions that are right for you.
I’m Dr. Carolyn
Clancy, and that’s my advice on how to navigate
the health care system.
More Information
Agency
for Healthcare Research and Quality
Treating High Cholesterol: A Guide for
Adults
http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=351&returnpage
Effective
Health Care Program
http://effectivehealthcare.ahrq.gov
American
Heart Association
Control Cholesterol
http://www.heart.org/HEARTORG/Conditions/Cholesterol/CholestrolATH_UCM_001089_SubHomePage.jsp 
Current as of August 2010
Internet Citation:
Treating High Cholesterol. Navigating
the Health Care System: Advice Columns from Dr.
Carolyn Clancy, August 3, 2010. Agency for
Healthcare Research and Quality, Rockville, MD.
http://www.ahrq.gov/consumer/cc/cc080310.htm
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