If your doctor has decided that you need to take medicine to reduce high cholesterol, it’s because you’re at high risk for heart disease or stroke. Usually the treatment combines healthy lifestyle changes including diet, physical activity and medicine.
Most heart disease and many strokes are caused by a buildup of fat, cholesterol and other substances called plaque in the inner walls of your arteries. The arteries can become clogged and narrow, and blood flow is reduced. If a blood clot forms and blocks blood flow to your heart, it causes a heart attack. If a blood clot blocks an artery leading to or in the brain, a stroke results.
By following your doctor’s advice, you can help prevent these diseases.
What type of medicine may I be prescribed?
Various medications can lower blood cholesterol levels. Statins are recommended for most patients because they are the only cholesterol-lowering drug class that has been directly associated with reduced risk for heart attack and stroke. Your doctor may consider other medications as well, especially if you have serious side effects or don’t have the desired response to statin therapy alone.
HMG-CoA reductase inhibitors (statins) stimulate the body to process and remove cholesterol. Their major effect is to lower LDL cholesterol. Some names are lovastatin, pravastatin simvastatin, fluvastatin and atorvastatin.
You should talk to your doctor about the risks and benefits of statin therapy if you fall into one of the following groups:
- Adults with known cardiovascular disease, including stroke, caused by atherosclerosis
- Adults with diabetes, aged 40-79 years with an LDL (bad) cholesterol level 70-189 mg/dL
- Adults with LDL (bad) cholesterol level of greater than 190 mg/dL
- Adults with LDL (bad) level of 70-189 mg/dL and a 7.5% or greater 10-year risk of developing cardiovascular disease from atherosclerosis
Some people who do not fall into these four major categories may also benefit from statin therapy.
What if statins don’t work for me?
If your healthcare provider determines that you can’t tolerate statins well or they are not working well for you, other medicines may be considered.
Bile acid binders (resins) help rid the body of cholesterol. Some names are cholestyramine, cholestipol and colesevelam.
Nicotinic acid or niacin is a B vitamin. Take this only if your doctor has prescribed it. It can lower total cholesterol, LDL (bad) cholesterol and triglyceride (blood fat) levels. It can also raise HDL (good) cholesterol levels.
Fibric acids are especially good for lowering triglyceride (blood fat) levels and, to a lesser extent, raising HDL (good) cholesterol levels. Some names are gemfibrozil, clofibrate and fenofibrate.
Your doctor will work with you to decide which medicine is best for you. Always follow your doctor’s instructions carefully, and let the doctor know if you have any side effects. Never stop taking your medicine on your own!
How do I know if my medicine is working?
Your doctor will test your blood cholesterol level when needed. Together with your doctor, set a goal and ask how long it may take to reach that goal.
- Call 1-800-AHA-USA1 (1-800-242-8721), or visit heart.org to learn more about heart disease and stroke.
- Sign up to get Heart Insight, a free magazine for heart patients and their families, at heartinsight.org.
- Connect with others sharing similar journeys with heart disease and stroke by joining our Support Network at heart.org/supportnetwork.
Do you have questions or comments for your doctor or nurse?
Take a few minutes to write your own questions for the next time you see your healthcare provider. For example:
What if I forgot a dose?
Should I avoid any foods or other medicines?
©2015, American Heart Association