Cholesterol Information
What is cholesterol?
Cholesterol and triglycerides are members of a family of molecules called lipids. Cholesterol is needed by the body to build cell walls, make hormones, and for other important processes. For many Americans there is too much cholesterol in the blood. This cholesterol can form plaque in the blood vessels. This condition is known as atherosclerosis. This condition is a major risk factor for heart disease, the number one killer for both men and women in the United States.
What are the types of lipoproteins that carry cholesterol?
- VLDL (very low-density lipoprotein) carries fat to different parts of the body. Once the fat is unloaded the remaining cholesterol and protein pieces form LDL.
- LDL (low-density lipoprotein) carries cholesterol to different parts of the body. It is considered "bad cholesterol" because the cholesterol it carries can become stuck inside blood vessels causing them to narrow.
- HDL (high-density lipoprotein) is considered "good cholesterol" because it picks up or scavenges cholesterol stuck in the blood vessels and carries it to the liver to be repackaged or broken down. Having high HDL levels can lower the risk of heart disease.
What are the symptoms of high cholesterol?
There are no symptoms of high cholesterol. Because there are no symptoms it is critical that screenings are done to make sure that your cholesterol is not too high.
What should my cholesterol numbers be?
Total Cholesterol
Less than 200mg/dL is desirable
200 - 239 mg/dL is borderline high
Greater than 240mg/dL is high
LDL Cholesterol
Less than 100mg/dL is optimal
100-129mg/dL is above optimal
130-159mg/dL is borderline high
160-189mg/dL is high
Greater than 190mg/dL is very high
* your personal goal for LDL cholesterol changes based on your other risk factors for developing heart disease
HDL Cholesterol
Less than 40mg/dL is low
Greater than 60mg/dL is high
*remember a high HDL level is good; HDL greater than 60mg/dl is considered a factor that reduces the risk of developing heart disease
Triglycerides
Less than 150mg/dL is normal
150-199mg/dL is borderline high
200-499mg/dL is high
Greater than 500mg/dL is very high
What are some of the risk factors for coronary heart disease?
Age - particularly men over 45 years old and women over 55 years old
Family history of heart problems (heart attacks, heart disease, stroke) in a brother or father less than 55 years old or a mother or sister less than 65 years old
High blood pressure or on a blood pressure medication
Cigarette Smoking
Diabetes
High total and LDL cholesterol and/or a low HDL cholesterol
Obesity
Physical inactivity
What are some ways to lower cholesterol?
Maintain a healthy body weight
Eat a healthy diet low in saturated fat and cholesterol
Exercise regularly
Medications in addition to a healthy diet and exercise may be necessary
What are the medications used to reduce cholesterol?
HMG-CoA Reductase Inhibitors (also known as "statins") work by blocking a certain step needed for the production of cholesterol.
Examples include:
atorvastatin (Lipitor®)
rosuvastatin (Crestor®)
simvastatin (Zocor®)
pravastatin (Pravachol®)
fluvastatin (Lescol/Lescol XL®)
lovastatin (Mevacor®)
Important reminders when taking these medications:
Take with evening meal or at bedtime for best results--the only exceptions are Lipitor® and Crestor® which can be taken anytime during the day
Inform your physician or pharmacist immediately if any muscle pain or weakness occurs while taking these medications
Your liver function should be monitored by your physician while taking these medications
Fibric Acid Derivatives work by helping the body break down triglycerides faster.
Examples include:
gemfibrozil (Lopid®)
fenofibrate (Tricor®, Trilipix®)
Important reminders when taking these medications:
Take this medication with food.
Your liver function should be monitored by your physician while taking these medications.
Inform your physician or pharmacist immediately if any muscle pain or weakness occurs while taking these medications.
Bile Acid Sequestrants work by preventing your body from absorbing bile acids from the intestine.
Examples include:
colestipol (Colestid®)
cholestyramine (Questran /Questran Light®)
colesevelam hydrochloride (Welchol®)
Important reminders when taking these medications:
Take other medications 1 hour before or 4 to 6 hours after taking bile acid sequestrants.
Gastrointestinal symptoms (abdominal pain, constipation, heartburn, nausea, vomiting) are common with these medications. Drink plenty of fluids with these medications.
Mix powder with fluids or applesauce, do not take in the dry powder form
Nicotinic Acid helps lower bad cholesterol (LDL) and raise good cholesterol (HDL); the mechanism of action is not completely understood.
Examples include:
niacin (Niaspan®)
Important reminders when taking these medications:
May cause gastrointestinal upset (nausea, bloating), take with food.
Often causes generalized flushing; taking an aspirin 30 minutes to 1 hour prior to your niacin dose will help prevent flushing. Check with your physician to make sure this is appropriate for you.
Do not crush sustained release formulations.
Niacin is available over-the-counter, but it can have serious adverse effects, so you should check with your physician before buying and using this product.
Omega-3 Fatty Acids help lower cholesterol; the mechanism of action is not completely understood.
Examples include:
Lovaza®
Fish oils (over-the-counter)
Important reminders when taking these medications:
Talk with your doctor before starting over the counter fish oil supplements.
May cause burping or fishy taste. Storing fish oil capsules in the refrigerator or freezer helps prevent these symptoms.
Do not take if allergic to fish.
Ezetimibe (Zetia®) helps block the absorption of cholesterol that comes from food.
Important reminders when taking this medication:
May be taken with or without food.
Your liver function may need to be monitored by your physician while taking this medication.
Inform your physician or pharmacist immediately if any muscle pain or weakness occurs while taking this medication.
