Cholesterol management strategies -
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.
Nutritional supplements. 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. A diet high in soy protein can slightly lower levels of total cholesterol, LDL cholesterol, and triglycerides and raise levels of high-density lipoprotein HDL cholesterol.
However, normal protein should not be replaced with soy protein or isoflavone supplements in an effort to lower cholesterol levels. Soy foods and food products eg, tofu, soy butter, edamame, some soy burgers are likely to have beneficial effects on lipids and cardiovascular health because they are low in saturated fats and high in unsaturated fats.
Garlic — Garlic has not been proven to be effective in lowering cholesterol. Plant stanols and sterols — Plant stanols and sterols may act by blocking the absorption of cholesterol in the intestine. They are naturally found in some fruits, vegetables, vegetable oils, nuts, seeds, and legumes.
Omega-3 fatty acids are an especially heart-healthy type of polyunsaturated fat. Trans fats are unsaturated fats that have been modified by a process called hydrogenation. This makes the unsaturated fats in vegetable oils more stable.
The body handles trans fats differently than other fats, and not in a good way. Trans fats increase LDL and total cholesterol while decreasing beneficial HDL. Soluble fiber is a type of fiber that is abundant in plants and whole grains. Prioritizing whole grains can help lower LDL cholesterol levels and may have a protective effect against cardiovascular diseases.
Some of the best sources of soluble fiber include:. Exercise is a win-win for heart health. Not only does it improve physical fitness and help prevent obesity , but it also reduces harmful LDL and increases beneficial HDL.
The American Heart Association AHA advises that minutes of moderate aerobic exercise per week is enough to lower cholesterol levels. Regular strength training alongside aerobic exercise can provide even more benefits. Having excess weight or obesity can increase your risk of developing high cholesterol levels.
Losing weight, if you have excess weight, can help lower your cholesterol levels. Overall, weight loss has a double benefit on cholesterol by decreasing harmful LDL and increasing beneficial HDL.
Consider working with a doctor to determine a nutrient-dense diet and sustainable weight management plan that works for you. Smoking tobacco increases the risk of heart disease in several ways, including:. Giving up smoking, if possible, can help reverse these harmful effects. According to a review of studies , some research indicates that when consumed in moderation, alcoholic drinks can increase good HDL cholesterol and reduce the risk of heart disease.
Yet the Centers for Disease Control and Prevention CDC and AHA disagree. The AHA does not recommend drinking wine or any other alcoholic beverage specifically to lower your cholesterol or improve heart health.
If you drink, the CDC suggests you consume only two drinks per day for males or one drink per day for females on days that you drink. Multiple types of supplements show promise for managing cholesterol. Plant stanols and sterols are plant versions of cholesterol.
According to a research review, clinical studies show that taking 1. Small amounts of plant stanols and sterols are naturally found in vegetable oils and are added to certain oils and butter substitutes.
You may also consider taking certain types of supplements. But speak with a healthcare professional before starting or changing your supplement regimen. Although food companies often advertise products as being low in cholesterol, research from shows that dietary cholesterol has only a small influence on the amount of cholesterol in your body.
That said, some foods high in soluble fibers, omega-3 fatty acids, or monounsaturated fats may help lower cholesterol, including:. Read more about saturated fat-rich foods here. Trans fats or, trans fatty acids are found in store-bought baked goods, snack foods and deep-fried foods.
There is strong evidence that trans fats increase levels of LDL cholesterol in the blood, while decreasing levels of HDL good cholesterol. Foods that contain cholesterol include liver, pate, kidneys, prawns and egg yolks.
Foods that contain saturated fats have a greater effect on blood cholesterol levels than foods that contain dietary cholesterol.
Replacing foods that contain mainly saturated fats with foods that contain unsaturated fats — such as polyunsaturated and monounsaturated fats — will help reduce your cholesterol level. Soluble fibre can reduce the absorption of cholesterol into your blood and it slows down digestion, making you feel fuller for longer.
Foods that are high in soluble fibre include:. Plant sterols are compounds that can lower LDL cholesterol. They occur naturally in plants, fruits, vegetables, nuts and grains and are added to some packaged foods, such as table spreads, cereals, low-fat yoghurt and low-fat milk.
Plant sterols that occur naturally in foods are only present in small amounts, compared with plant sterols that are added to foods. Adding plant sterol-enriched foods to your diet is the most effective dietary change you can make to reduce your LDL cholesterol.
Vigorous aerobic exercise is best. Moderate-intensity exercise is a level that increases your heart rate and breathing but allows you to keep talking. Vigorous intensity exercise makes your heart rate higher and makes you breathe more heavily. Resistance training using weights, resistance bands or your own body weight and muscle-toning exercises can increase HDL cholesterol.
Aim to do this twice a week. If you are obese or overweight, losing weight can help reduce your levels of LDL cholesterol and triglycerides, while increasing your levels of HDL cholesterol. Alcohol can increase your levels of triglycerides. Along with LDL cholesterol, high levels of triglycerides raise your risk of heart disease.
Excess alcohol consumption also increases blood pressure and can lead to obesity due to the kilojoules in alcohol — both additional risk factors for heart disease.
To reduce the risk of heart disease and other risks from alcohol, limit your intake to no more than 10 standard drinks per week and no more than 4 drinks per day. Smoking reduces HDL cholesterol and speeds up the rate at which fatty plaques form in the walls of your arteries. It also makes your blood more likely to clot.
These factors increase your risk of heart attack and stroke. Stopping smoking is one of the best ways to improve your heart and blood vessel health. Your doctor can help you quit smoking. You can also call the Quitline on 13 to talk to a counsellor, or use its online chat service.
Aboriginal Quitline can also support Aboriginal and Torres Strait Islander people who smoke. As well as making lifestyle changes, some people will need to take cholesterol-lowering medicines to reduce their risk of heart and blood vessel disease, known as cardiovascular disease.
The medicines most commonly used are called statins. Your doctor will consider all your risk factors for cardiovascular disease before suggesting medication — not just your cholesterol and lipid results. Statins work by slowing the amount of cholesterol made in your liver.
In response, your liver uses the cholesterol already in your blood to make up for the deficit. This lowers the level of LDL cholesterol in your blood. Contact your doctor if your medicines are causing any side effects. An accredited practising dietitian can design a personalised eating plan for you to lower your cholesterol.
Find one at Dietitians Australia. Learn more here about the development and quality assurance of healthdirect content. Understanding what blood cholesterol is and how to control it can help you reduce your risk of heart disease and other serious conditions.
Read more on Heart Foundation website. Abnormally high cholesterol levels may not give you any symptoms, so a blood test is the best way to check whether you have high cholesterol. Read more on myDr website.
Strategifs websites use. gov A. gov website Cholesterol management strategies to an official government organization in the United States. gov website. Share sensitive information only on official, secure websites. Your body needs some cholesterol to work properly. Cholesterol management strategies treat unhealthy blood cholesterol levels, your doctor may recommend heart-healthy lifestyle manageemnt Cholesterol management strategies prescribe Cohlesterol. If Cjolesterol medical srrategies Cholesterol management strategies Choletserol is causing your blood cholesterol problem, your Natural energy boosters may treat that condition or change your medicine or its dose. Talk with your doctor about your cholesterol levels, your risk of developing heart disease, other medical conditions you have, and your lifestyle. You can learn about the benefits and side effects of medicines for lowering your blood cholesterol. Together, you can set up a treatment plan that will work for you. We lead or sponsor many studies on high blood cholesterol.Cholesterol management strategies -
And you have lots of options: brisk walking, swimming, bicycling or even yard work can fit the bill. Worse still, when a person with unhealthy cholesterol levels also smokes, risk of coronary heart disease increases more than it otherwise would.
Smoking also compounds the risk from other risk factors for heart disease, such as high blood pressure and diabetes. By quitting, smokers can lower their LDL cholesterol and increase their HDL cholesterol levels.
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.
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Eat foods naturally high in fiber, such as oatmeal and beans black, pinto, kidney, lima, and others , and unsaturated fats, which can be found in avocados, vegetable oils like olive oil, and nuts. Find healthy, seasonal recipes at the Million Hearts ® healthy recipes page.
Maintain a healthy weight Talk with your doctor about what a healthy weight is for you. Last Reviewed: May 16, Source: National Center for Chronic Disease Prevention and Health Promotion , Division for Heart Disease and Stroke Prevention.
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This puts you at risk for coronary artery disease and other heart diseases. Cholesterol travels through the blood on proteins called lipoproteins. One type, LDL , is sometimes called the "bad" cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries.
Another type, HDL , is sometimes called the "good" cholesterol. It carries cholesterol from other parts of your body back to your liver. Then your liver removes the cholesterol from your body. The treatments for high cholesterol are heart-healthy lifestyle changes and medicines.
The lifestyle changes include healthy eating, weight management, and regular physical activity. Heart-healthy lifestyle changes include a diet to lower your cholesterol. The DASH eating plan is one example. Another is the Therapeutic Lifestyle Changes diet, which recommends that you. Choose healthier fats.
You should limit both total fat and saturated fat. Depending upon how many calories you eat per day, here are the maximum amounts of fats that you should eat:.
Saturated fat is a bad fat because it raises your LDL bad cholesterol level more than anything else in your diet. It is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.
Trans fat is another bad fat; it can raise your LDL and lower you HDL good cholesterol. Trans fat is mostly in foods made with hydrogenated oils and fats, such as stick margarine, crackers, and french fries. Instead of these bad fats, try healthier fats, such as lean meat, nuts, and unsaturated oils like canola, olive, and safflower oils.
Limit foods with cholesterol. If you are trying to lower your cholesterol, you should have less than mg a day of cholesterol. Cholesterol is in foods of animal origin, such as liver and other organ meats, egg yolks, shrimp, and whole milk dairy products.
Error: Cholesterol management strategies is required. Error: Not a valid Cholestero. Cholesterol strategied a Cnolesterol of Sunflower seed oil which is Cholesterol management strategies by your body to build and repair cells and to make hormones. Your liver makes cholesterol, and some foods contain it. There are different types of cholesterol, and each is named after the different proteins that carry cholesterol in the blood. The key ones are:.
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