Treating High Cholesterol

November 2005

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Treating High Cholesterol

Posted: Nov. 1, 2005

High cholesterol is treated with lifestyle modifications and, when needed, medications.

Diet
A low-saturated-fat, low-cholesterol eating plan calls for less than 7 percent of calories from saturated fat and less than 200 mg of dietary cholesterol per day. If your LDL is not lowered enough by reducing your saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Certain food products that contain plant stanols or plant sterols (for example, cholesterol-lowering margarines) also can be added to your diet to boost its LDL-lowering power.

Foods low in saturated fat include fat-free or 1 percent dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarines (liquid or tub varieties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level).

Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products.

Good sources of soluble fiber include oats, certain fruits (such as oranges and pears) and vegetables (such as brussels sprouts and carrots), and dried peas and beans.

Physical activity
Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone. It can help raise HDL and lower LDL and is especially important for those with high triglyceride and/or low HDL levels who also are overweight with a large waist measurement.

Drug treatment
Even if you begin drug treatment to lower your cholesterol, you will need to continue with lifestyle changes. This will keep the dose of medicine as low as possible.

There are several types of drugs available for lowering cholesterol including statins, bile acid sequestrants, nicotinic acid, fibric acids, and cholesterol absorption inhibitors.

The statin drugs are very effective in lowering LDL levels and are safe for most people.
Bile acid sequestrants also lower LDL and can be used alone or in combination with statin drugs.
Nicotinic acid lowers LDL and triglycerides and raises HDL.
Fibric acids lower LDL somewhat but are used mainly to treat high triglyceride and low HDL levels.
Cholesterol absorption inhibitors lower LDL and can be used alone or in combination with statin drugs.

Source: National Heart, Lung and Blood Institute

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