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Writer's pictureElena Cora

Beyond the Basics: A Comprehensive Guide to Managing High Cholesterol

When lifestyle modifications alone aren't enough to reduce cholesterol levels, doctors may recommend medication. There are various medications available, including statins and plant stanols.


Statins (HMG CoA reductase inhibitors) are among the most frequently prescribed treatments for high cholesterol, and can lower your risk of heart disease and stroke by 25 percent or more.




Cholesterol absorption inhibitors


Low levels of cholesterol are essential to good health; however, when levels become elevated they increase your risk for heart disease and stroke. Diet and exercise alone may help lower cholesterol; however if genetic or other issues make reaching healthy cholesterol levels challenging to achieve through diet and exercise alone then medicine may be required to help reach that goal.


Cholesterol absorption inhibitors like Ezetimibe are proven to lower cholesterol by blocking its absorption by the small intestine, thus decreasing how much is delivered to the liver, increasing hepatic LDL receptor activity, and ultimately leading to reduced levels of circulating cholesterol.


Ezetimibe is one of the first selective cholesterol absorption inhibitors, an effective LDL-C lowering agent, either alone or combined with statins; especially useful in patients suffering from HoFH and sitosterolemia.


PCSK9 drugs


PCSK9 inhibitors help to significantly lower LDL cholesterol in the bloodstream while simultaneously increasing levels of good (HDL). Repatha (evolocumab) and Praluent (alirocumab) are two available PCSK9 inhibitors; both require regular injections under the skin.


These drugs may not be appropriate for everyone; they should only be prescribed after having had a heart attack, stroke or major cardiovascular event, as well as having familial hypercholesterolaemia genetic disorder. They work best when combined with statins to lower your risk of future cardiovascular events high cholesterol ka desi ilaj


These medications work by binding to a liver protein that destroys LDL receptors. By stopping its work, more LDL receptors become available to remove cholesterol from your bloodstream. Regular blood tests will need to be conducted to check how effective this drug is; injections can either be given by hospital staff or your GP practice, or you may learn how to give yourself.


Sequestrants

Bile acid sequestrants bind with cholesterol and triglycerides in the digestive tract to block their absorption back into the blood. Once bound, these medications can then be excreted through feces - making bile acid sequestrants ideal for use alongside statins to achieve goal lipid levels and decrease coronary heart disease risk.

 

So-called statin drugs may also be used alone to treat patients with mild to moderate hypercholesterolemia; however, these do not decrease cardiovascular events in patients who already have established heart disease.


Welchol (colesevelam), Colestipol and Prevalite (cholestyramine) are available as tablets while Prevalite is a resin powder; all three medications may help patients meet target LDL-C goals in patients who cannot tolerate statins or do not respond to other lipid-lowering therapies.


Long-term use of bile acid sequestrants increases the risk for side effects such as diarrhea and stomach upset, as well as binding with certain other drugs to decrease their absorption, such as warfarin (Coumadin), thyroid hormones (Levothroid, Synthroid), digoxin (Lanoxin) or thiazide diuretics such as Hydrodiuril Oretic or Dyazide) leading to decreased absorption. This may result in deficiencies of these essential medications being available.


Statins

If a heart-healthy diet and lifestyle changes don't suffice in lowering cholesterol enough, doctors often recommend statin drugs to further decrease levels. These medicines interfere with liver production of cholesterol while simultaneously lowering LDL (or "bad") levels; additionally they help prevent plaque buildup in your arteries which could otherwise lead to heart attacks or strokes.


These drugs - commonly referred to as HMG-CoA reductase inhibitors -- work by blocking an enzyme your body uses to produce cholesterol, thus decreasing levels of bad cholesterol while possibly raising levels of good ones. They should be taken once daily as pills, chewable tablets or liquids, with brand names including Atorvastatin, Rosuvastatin, Fluvastatin and Simvastatin being popular brands - or they can even be combined together on one tablet like Zetia (for instance).


Ezetimibe works to decrease absorption of cholesterol from food, so it works alongside statins to further lower your cholesterol levels. Unfortunately, however, pregnant women and those with active liver disease aren't recommended taking these medicines; additionally they can cause muscle issues and interact with certain jigar ki charbi ka ilaj in urdu.

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