Your health care provider has prescribed medication to help control your cholesterol. This sheet tells you how cholesterol affects your health. It also explains how medications can help improve your cholesterol levels.
Cholesterol is a type of fat (lipid) that’s carried in the blood. Your body makes cholesterol in the liver. You also get it from certain foods. The body needs some cholesterol to stay healthy. But high cholesterol increases buildup of plaque (a fatty substance) in the blood vessels. Over time, this plaque narrows and hardens the blood vessels. This reduces or blocks blood flow in these vessels and raises your risk of heart attack (also known as acute myocardial infarction, or AMI), stroke, and other health problems. This is known as atherosclerotic cardiovascular disease (ASCVD).
There are three key fats in the blood:
LDL (low-density lipoprotein) cholesterol. This is called “bad” because it can cause plaque buildup in the blood vessels.
HDL (high-density lipoprotein) cholesterol. This is called “good” because it helps remove harmful cholesterol from the bloodstream.
Triglycerides. These are a primary form of fat your body uses to store energy. Like LDL cholesterol, they can cause plaque buildup in the blood vessels.
You can find out your levels by having a blood test. High blood cholesterol is a risk factor for getting ASCVD. Talk to your health care provider about what levels are best for you. To find out more about cholesterol levels, visit www.heart.org/cholesterol.
Medications can help control the amount of cholesterol in the blood. There are several types. Each controls cholesterol in a different way. They also have different effects in terms of how well they work to lower cholesterol and reduce death rates. Discuss these effects with your health care provider. Your health care provider will prescribe the type of medicine that is best for you. They may be used alone or combined. The main types are:
Statins (HMG-CoA reductase inhibitors). Statins are thought to be the best at lowering cholesterol. They do this by keeping the body from making cholesterol. Benefits: Statins lower LDL cholesterol. They also slightly raise HDL cholesterol and lower triglycerides.
Selective cholesterol absorption inhibitors. These prevent the body from taking cholesterol from food. They may be prescribed for use alone or with a statin. Benefits: These medications lower LDL cholesterol. They also slightly raise HDL cholesterol and lower triglycerides.
Resins (also called bile acid sequestrants or bile acid-binding drugs). Resins promote increased disposal of cholesterol through the intestines. They work by binding to bile (a substance that helps the body digest food). The body uses cholesterol to make bile. Normally, most bile is absorbed by the body during digestion. But when bile is bound to resin, it is excreted from the body. So, the body must make more bile. To do this, the body takes up more cholesterol from the blood. Benefits: Resins lower LDL cholesterol.
Fibrates (fibric acid derivatives). These are best at reducing the amount of triglycerides the body makes. They are not very effective lowering LDL. Benefits: Fibrates lower triglycerides. They also raise HDL cholesterol.
Niacin (nicotinic acid). Niacin (vitamin B3) affects how the liver makes blood fats. (Note: Non-prescription niacin should not be used to treat cholesterol problems as it is not regulated by the FDA.) Benefits: Niacin raises HDL cholesterol. It also lowers triglycerides and LDL cholesterol.
Omega-3 fatty acids. These reduce the amount of triglycerides the body makes. They also help to clear these lipids from the blood. Omega-3 fatty acids are found in many foods. These include salmon and other oily fish, and walnuts. Your health care provider may prescribe these fatty acids in capsule form. Benefits: Omega-3s lower triglycerides. (Note: They may increase LDL cholesterol in some patients.)
Take your medication exactly as your health care provider instructs. This will help it work best. Here are tips for taking cholesterol medications:
Know when and how to take your medications. Some may need to be taken with food. Others may need to be taken on an empty stomach or at a certain time of day.
Stick to a schedule. Try the following:
Don’t skip doses or stop taking your medication. This is important even if you feel better or if your cholesterol numbers improve.
Set things up to help you remember. For instance, work taking your medications into your routine. You could plan to take them when you get up in the morning or when you go to bed at night.
Keep track of what you take. You may take a few different medications. If so, a list or chart can help you take the right pills at the right time. A pillbox with days of the week or times of day is also a good tool for keeping track.
Prevent drug interactions. Some medications and supplements can interact with one another (affect how other drugs work when taken together). Be sure to tell your health care provider about all other medications you take. This includes vitamins, herbs, and over-the-counter medications.
Know how to deal with side effects. Many people have side effects when they first start taking a medication. These are things like headache and stomach upset. Side effects should go away in a few weeks. Tell your health care provider about any side effects you have. Certain side effects should be reported to your health care provider right away. These include yellowing of the eyes and blurred vision. Also report muscle aches and breathing problems.
Note: If you are pregnant or breastfeeding, tell your health care provider before taking any cholesterol medications.
Your health care provider will help you make changes your lifestyle if needed. These changes are needed to help you lower your cholesterol and keep the ASCVD from getting worse. Things you may need to work on are:
Your health care provider will give you information on changes that you may need to make to your diet. You may need to see a registered dietitian or nutritionist for help with these changes. You might be asked to:
Eat less meat containing saturated fat and high levels of cholesterol
Eat less sodium (salt), especially if you have high blood pressure
Eat more fresh vegetables and fruits
Eat lean protein, like fish, chicken and turkey, and beans and peas
Eat less processed meats, like deli meats, sausage, and pepperoni
Choose non-fat and low-fat milk, yogurt and cheese
Use vegetable and nut oils instead of butter, shortening, and margarine
Limit sweets and packaged foods, like chips, cookies, and baked goods
Your health care provider may ask you to be more active. Depending on your health, your provider may recommend that you get moderate to vigorous intensity exercise for at least 40 minutes each day, 3 to 4 days each week. Some examples of moderate to vigorous exercise are:
Walking at a brisk pace, about 3-4 miles per hour
Jogging or running
Riding a bicycle or stationary bike
Swimming or water aerobics
You may not be able to do 40 minutes right away. You may have to start with 5 to 10 minutes a day, 2 times a day, and then keep adding to it until you can do 40 minutes.
If you are overweight or obese, your health care provider may tell you to lose weight and lower your BMI (body mass index). Changing your diet and getting more exercise can help.
If you smoke, quit now. Ask your health care provider for information on medications that can help you fight cravings. Enroll in a stop-smoking program to improve your chances of success.
Learn ways to help you deal with stress in your home and work life. Here are a few ideas:
Take a yoga class. You can find classes at local community centers or on the Internet.
Get regular exercise. Exercise helps your mind let go of problems and release stress in your muscles.
Deep breathing. Take a few minutes several times a day to just sit quietly and breathe. Concentrate on the air going into and out of your body.