Last modified on 29 July 2009, at 13:01

What You Should Know About Medicines/Anticholesterols

There are several types of medications used to lower cholesterol. But first, a few words on what the problem is.

In the human body, cholesterol is an important chemical, which is used to make vital hormones like testosterone and estradiol. It is manufactured in the body, or can be ingested in the diet, and absorbed in the intestinal tract.

There are several subtypes of cholesterol. When one says "my cholesterol is good", it usually refers to the total cholesterol. There is one subtype called high density lipoprotein (HDL for short), which is considered the "good" cholesterol. The higher this is, the better. Another subtype is called low density hypoprotein, or "bad" cholesterol. Over the years, physicians have been lowering what they consider to be "safe" LDL, and for most people it is now lower than 100. (For people at "high risk" of complications, like diabetics, it is below 70.) There are other subtypes as well, but they are less important clinically.

The evidence for high cholesterol being linked to cardiovascular disease like heart attacks and strokes took decades to glean from the data of hundreds of scientific studies. Even though the cholesterol values currently account for only about 50% of the causes of cardiovascular disease, efforts to lower these levels have resulted in dramatic drops in morbidity and mortality. So much effort is expended to aid people in understanding what their personal cholesterol levels are, how their diet can contribute to it, and if high, how changing their diet and other lifestyle parameters can reduce their risk.

Some medications to lower cholesterol work by trying to "bind" it in the intestinal tract before it actually enters the blood stream. Although this can work for some people, and a high fiber diet that helps is nearly always good for us, it is unlikely to change the cholesteral values much by itself.

The most commonly prescribed cholesterol lowering medications in the US today are called statins, for short. They include medications with names like Lipitor, lovastatin, mevacor, etc. They work quite well for most people, and some work better than others. Your clinician can help chose the one for you. They have a serious side effect of damaging muscles, which is uncommon, but not rare. After going on a statin, your clinician should draw blood to ensure the medication is not causing you harm.

Niacin is another cholesterol lowering medication, usually taken as a powder. It's side effects include "flushing", where one turns red, like a menopausal hot flash.