Text Box: 3. How do you diagnose high cholesterol? High cholesterol is often called hyperlipidemia. It is diagnosed by doing blood tests. Blood tests usually measure four different types of lipids (fats) in your blood: LDL (“bad”) cholesterol, HDL (“good”) cholesterol, total cholesterol and triglycerides. For the average person lipid goals should be: total cholesterol less than 200, triglycerides less than 150, LDL less than 160, 130 or 100 (depending on your risk factors) and HDL greater than 40. Goals for your cholesterol levels will be set by your physician and are based on several risk factors you may or may not have. 4. My physician tells me I have high cholesterol and should start medication. Is there anything else I can do? And will it work or should I just give up and start medicine? Depending on your cholesterol levels, you may be able to try some Therapeutic Lifestyle Changes (TLC). Many people have successfully lowered their cholesterol by making and sticking to these lifestyle changes. The changes you can make are: eating a heart healthy diet that is low in saturated fat, total fat and cholesterol, stop smoking, exercise regularly, and lose weight. 5. I have made changes in my diet and exercise and my cholesterol numbers are not changing. My physician told me I needed to start medications. Are they safe? Do they work? Are there any herbals or supplements I can try on my own? Cholesterol lowering medications can be very safe and effective. There are four main classes of medications, each working in a different way. 1. “Statins:” The most common cholesterol lowering medications are known as the “statins” because of

Text Box: their chemical (generic) names (they all end in –statin). Statins really belong to a class of drugs called the HMG CoA Reductase inhibitors. This is a fancy name for one enzyme in the body that is part of the pathway that makes cholesterol. By inhibiting, or blocking, this enzyme, we block the production of cholesterol. Atorvastatin (Lipitorâ), Fluvastatin (Lescolâ), Lovastatin (Mevacorâ), Pravastatin (Pravacholâ), Rosuvastatin (Crestorâ), and Simvastatin (Zocorâ) are all medications that are in this class. Statins lower LDL (“bad”) cholesterol and triglycerides and raise HDL (“good”) cholesterol. 2. Fibric acid derivatives: “Fibrates” are a class of drugs that work mainly on lowering triglyceride levels. They also lower LDL (“bad”) cholesterol and raise HDL (“good”) cholesterol. Their exact mechanism is still not completely understood, but their effects on lipids are widely studied. Gemfibrozil (Lopidâ) and Fenofibrate (Tricorâ) are medications in this class. 3. Ezetimibe: Ezetimibe (Zetiaâ) is in a class all of it’s own and it does not really have a class name. Ezetimibe works by blocking absorption of cholesterol in the small intestines from the food that you eat. 4. Resins: Resins are also known as bile acid sequestrants. What this means is that the medications bind to bile acids in the intestines and stop them from being absorbed into the blood stream, instead they pass on through. This causes the liver to make more bile acids from cholesterol, thus lowering choles

Text Box: terol levels in the blood. Cholestyramine (Questranâ, Prevaliteâ, Lo-Cholestâ), Colestipol (Colestidâ) and Colesevelam (WelCholâ) are all medications in this class. 5. Dietary Supplements: Niacin and Fish Oil have show benefits in lowering blood cholesterol levels. Both are available over-the-counter in many retail stores, however, it is wise to discuss them with your physician to determine if they would benefit you. Some physicians will recommend prescription strength niacin for their patients because of a lower incidence of flushing (a side effect common with niacin). Always remember that herbal products are not regulated by the FDA (Food and Drug Administration) and may vary in their strength and effectiveness. For more information about cholesterol, testing, medications and options for you, please contact your physician or other health care provider. While the following internet sites are not replacements for talking with your health care provider, they do offer good information. www.healthfinder.gov www.nhlbi.nih.gov/chd/ www.americanheart.org www.nlm.nih.gov/medlineplus/cholesterol.html

Cholesterol ?!?! (continued)

Contributed by: Rebecca Anderson, Pharm.D. Candidate

KU School of Pharmacy