Fast Facts

• High cholesterol can lead to heart attacks and strokes.
• There are different kinds of medicines to treat high cholesterol.
• Medicines called statins are used the most.
• If your cholesterol is still too high when you are taking a statin, there are options. Your doctor or nurse can increase your statin dose or add a different kind of cholesterol medicine.
• Research can’t tell us yet if taking a statin and another kind of cholesterol medicine lowers cholesterol more than taking only a statin.
• Research also can’t tell us yet if taking a statin and another kind of cholesterol medicine helps prevent more heart attacks or strokes than taking only a statin.

What Does This Guide Cover?

Keeping your cholesterol at a good level can help lower your chance of heart attacks and strokes. This guide can help you talk with your doctor or nurse about medicines to treat high cholesterol. It covers:

• Different kinds of cholesterol medicines.
• How the medicines work.
• Side effects of cholesterol medicines.
• The information in this guide comes from a government-funded review of research about cholesterol medicines.

What Is Not Covered in This Guide?

This guide does not compare all the ways to lower cholesterol. It does not compare cholesterol medicines with herbal treatments or dietary treatments (like oatmeal). It also does not compare all the combinations of medicines. This guide does not cover the treatment of high cholesterol in people under 18 years old.

Learning About Cholesterol

Cholesterol is a building block of our body’s cells. The liver makes cholesterol. Cholesterol travels to the body’s cells in the blood. We all need some cholesterol, but our bodies can make all the cholesterol we need. Certain foods are an added source of cholesterol.

Many people have the right amount of cholesterol. Other people have too much. High cholesterol sometimes runs in families.

There are different types of cholesterol. The two main types are often called “bad” and “good.” The bad cholesterol can damage the heart and arteries, but good cholesterol does not cause damage.

Bad Cholesterol (LDL Cholesterol)

Everyone should try to keep bad (LDL) cholesterol as low as possible. If your doctor or nurse tells you that you have high cholesterol, it means that your bad cholesterol is too high.

When you have too much bad (LDL) cholesterol in your blood, it can build up on the walls of your arteries. This buildup is called plaque (pronounced “plak”). Plaque can narrow your arteries and make it harder for blood to flow. Plaque can lead to heart attacks and strokes. Keeping bad cholesterol at a low level can help avoid these problems.

Setting Your Cholesterol Goal

The target for your bad (LDL) cholesterol depends on your risk factors for heart disease. Risk factors are things that increase your chance of having a heart attack or stroke. If you have more risk factors, your doctor or nurse will recommend a lower target for your bad cholesterol. Talk with your doctor or nurse about setting your cholesterol goal.

How Is High Cholesterol Treated?

The first step in controlling your cholesterol is to eat a balanced diet and to be more active. Even small changes can make a big difference. Your doctor or nurse may recommend a special cholesterol-lowering diet. The cholesterol-lowering diet follows simple guidelines like:

• Eating a variety of foods, including fresh fruits, vegetables, and whole grains.
• Limiting fat calories to 35 percent or less of total calories eaten each day.
• Limiting foods with cholesterol in them, like egg yolks.
• Eating foods with fiber in them, like whole grains.

Some people can reach their cholesterol goals by eating a balanced diet and exercising. But many people will also need medicine to lower their cholesterol.

Learning About Cholesterol Medicines

Different kinds of cholesterol medicines work in different ways to improve your cholesterol levels. Some medicines can lower your triglycerides. Most people start with a statin because statins usually work well to lower bad (LDL) cholesterol. If your bad cholesterol is still too high, your doctor or nurse may increase your statin dose or add a different kind of cholesterol medicine to help you reach your goal. This chart shows the different kinds of cholesterol medicines and how they work.

Are Two Medicines Better Than One?

Side Effects of Cholesterol Medicines

Talking With Your Doctor About High Cholesterol

Track Your Cholesterol Levels

Use this table to track your cholesterol levels. Each time you have your cholesterol checked, fill in a row of the table. That way, you and your doctor or nurse will be able to see how your levels change over time.

Track Your Cholesterol Medicines

Use this table to keep a record of the cholesterol medicines you take. It will help you keep track of the medicines that work best for you.

For More Information

Visit www.effectivehealthcare.ahrq.gov.

Click on Guides for Patients and Consumers to print a copy of this guide and learn about other conditions.

For free print copies of this guide, call 800-358-9295. Ask the Publications Clearinghouse for AHRQ Publication Number 09(10)-EHC024-A.

To learn more about cholesterol, visit www.nlm.nih.gov/medlineplus/cholesterol.html.

Source

The information in this guide comes from a detailed review of 102 research reports. The review is called Comparative Effectiveness of Lipid-Modifying Agents (2009), and was written by the Johns Hopkins Evidence-based Practice Center.

The Agency for Healthcare Research and Quality (AHRQ) created the Eisenberg Center at Oregon Health & Science University to make research helpful for consumers. This guide was written by Bruin Rugge, M.D., Martha Schechtel, R.N., Rachelle Nicolai, B.A., Susan Severance, M.P.H., and David Hickam, M.D., of the Eisenberg Center. People with high cholesterol helped them develop this guide.