High Cholesterol: Treatment

Reviewed by Andrew M. Freeman, MD, FACC, FACP

High cholesterol levels are treated with diets low in cholesterol, medications, and lifestyle modifications. There is also increased emphasis on other risk factors for cardiovascular disease, such as high blood pressure.

Treatment is most commonly with lifestyle change: increasing exercise, avoidance of excess carbohydrates and fatty foods, decreased animal products in the diet. If these lifestyle changes don't produce the necessary result, oftentimes, doctors will use medications such as statins (HMG CoA reductase inhibitors) to reduce LDL and boost HDL cholesterol. There are also many other drugs and supplements to help with cholesterol.

It is important to note that a healthy lifestyle with moderate physical activity 30 minutes a day combined with a mostly plant-based diet is probably the best, no-cost, and most highly effective option as a first step toward improved cholesterol levels.

Drug treatment controls but does not "cure" high blood cholesterol. Therefore, you must continue taking your medicine to keep your cholesterol level in the recommended range.

Five major types of cholesterol-lowering medicines are:

  • Statins

    • Lowers LDL cholesterol

  • Bile Acid Sequestrants

    • Lowers LDL cholesterol

  • Nicotinic Acid

    • Lowers LDL cholesterol and triglycerides, and raises HDL cholesterol

  • Fibrates

    • Lowers triglycerides and may increase HDL cholesterol

  • Ezetimibe

    • Lowers LDL cholesterol


Treatment Goals

Treatment is tailored to your individual risk of developing heart disease. Some patients need to have an LDL less than 100 or even 70 mg/dL, but you and your doctor can work on these plans together. Below is just one example of some treatment goals. As always, consult your physician for complete information on your individual needs.

  Cholesterol Treatment Panel

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