How to reduce cholesterol? Why medicines are used to Lower high cholesterol ?
Which medicines are given to treat hypercholesterolemina ?
Higher level of cholesterol in body is very dangerous as it may block coronary arteries and may cause heart failure, cholesterol tend to form fatty plaques in veins and arteries, which when dislodged may occlude blood flow, if the artery that get occlusion is one that supply blood to brain in is very serious situation it can cause stroke, by virtue of occlusion of blood flow to brain.
Therefore it is must that one should not discontinue cholesterol reducing medicines without consultation of a doctor who is giving treatment for your increased cholesterol.
Cholesterol can be reduced by changing following things
A) Exercise combined with controlled diet:
1) Perform everyday physical activity or exercise that gives workout to your leg and thigh muscles and abdomen and arms. Morning breakfast with no or very low fat, butter should be avoided in breakfast, a breakfast containing lots fruits are found to reduce cholesterol and also gives very healthy body.
2) Afternoon meal and dinner should contain low fat, meat can be avoided if you require to eat a high protein diet, eat egg white portion only, avoid eating egg yolk consist of 1090 mg of cholesterol which is almost 360% of total requirement of cholesterol of from a single diet. Hence avoid eating egg yolk.
3) If you can avoid heavy dinner, just have few items just enough to give your health support.
4) Avoid eating late in night after 9:30 PM one should not eat heavy dinner, after 11:00 pm one should avoid dinner, and just have a glassful of hot milk.
Diet control is very important factor for reducing cholesterol, even though if cholesterol is keeping on high it is because of major change in metabolism of your body, it can be because of liver disease or disease that affects liver.
Following drugs are used to treat hypercholesterolemia:
Statin are group of drug which inhibit enzyme HMG-CoA reductase hence are also called as HMG-CoA reductase inhibitors, they reduce LDL level by inhibiting LDL production in liver, Statins have a risk of increased muscle damage and rabhdomylosis hence it should be used with caution in patient with muscle damage.
1) Atorvastatin (Lipitor),
2) Fluvastatin (Lescol),
3) Lovastatin (Mevacor, Altocor),
4) Pitavastatin (Livalo),
5) Pravastatin (Pravachol),
6) Rosuvastatin (Crestor)
Nicotinic acid or niacin, Niacin is also known as B3 :
Niacin is required for production of coenzymes nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP) which controls fat and lipid metabolism, niacin is able to reduce triglyceride level in blood up to some extent , thereby reducing total cholesterol in blood, niacin. It does not reduce cholesterol rather taking niacin help in reducing total usage of fat for energy production in body.
Fibrates: Group of drugs are effective in reducing occurrence of heart attack by virtue of lowering total cholesterol , it does not lower LDL rather it increase HDL and lower triglycerides. Most of the times fibrate class of drugs are combined with statin when or given alone when statins are not tolerated by patient. Fibrate group of drug increase concentration of cholesterol in bile hence it increase risk of bile stone formation, hence care must be taken for patients for monitoring bile stone formation if patient is on longer duration on fibrates. Side effect of statins include myopathy and rhabdomylosis Fibrate class of drug should not be taken along with cholchicine as it can case myopathy. Periodic level of HDL must be monitor as it is found that it may cause sudden decrease in HDL level. Following are the drugs.
Clofibrate (not recommended as it may cause side effect casing gallstones)
Ezetimibe : This drug lowers cholesterol by reducing re-uptake of cholesterol in small intestine thereby allowing excretion of more amount of cholesterol, This should not be used unless there is no option.
Bile acid sequestrants:
These group of drugs are particularly effective in lowering of cholesterol by binding with free cholesterol in bile so that when it is released in intestine reabsorption of cholesterol in intestine is reduced. Cholestyramine is the drug belonging to this class, it may reduce reabsorbtion of other drugs as well.
Lomitapide : This drug inhibit microsomal triglyceride transfer protein hence called as (MTP) inhibitor
Pancreatic lipase inhibitor : orlistat drug inhibit enzyme lipase which breakdown lipid from food in to absorbable form, this drug help in reducing triglyceride level.
Guidelines for treatment for cholesterolemia.