Step 7: Cholesterol-Lowering Drugs

There are several types of drugs available to help lower blood cholesterol levels, and they work in different ways. Some are better at lowering LDL (bad) cholesterol, some are good at lowering triglycerides, while others help raise HDL (good) cholesterol.

Whether or not you need a medication depends on how high your LDL levels are, your risk factors for heart disease (or whether you have it already), age, smoking habits, and other considerations. Unless you are at high risk, your doctor would want to try to control your cholesterol through diet, exercise, and weight loss first, and see if that brings your cholesterol down sufficiently so that medication is not needed. But, depending on your risks, your doctor may want you to start medication sooner.

Following the latest guidelines, your doctor will start or consider medication when:

• Your LDL cholesterol is 190 mg/dL or higher.
• Your LDL cholesterol is 160 mg/dL or higher AND you have one risk factor for heart disease.
• Your LDL cholesterol is 130 mg/dL or higher AND you have either diabetes or two other risk factors for heart disease.
• Your LDL cholesterol is 100 mg/dL or higher AND you have heart disease. (If you have diabetes, even if you don't have known heart disease, medication may be considered for an LDL cholesterol of 100 mg/dL)
• Your LDL cholesterol is greater than 70 mg/dL AND you have had a recent heart attack or have known heart disease along with diabetes, current cigarette smoking, poorly controlled high blood pressure, or the metabolic syndrome (high triglycerides, low HDL, and obesity).

If your doctor has established that diet, exercise, and weight control are not sufficient and that medication is needed, it is possible that you will need to be on the medication for the rest of your life. That is because high cholesterol returns quickly once the effective therapies are taken away.

If you need medication, your physician will prescribe the one best suited to your condition. Remember to take your medication consistently.

Learn More Drug Treatments: Bile Acid Resins Drug Treatments: Cholesterol Absorption Inhibitors Drug Treatments: Fibrates and Probucol Drug Treatments: Nicotinic Acid Drug Treatments: Statins (most widely used)

In some cases, your physician may prescribe more than one cholesterol-lowering drug. (For more information on combination drug therapy, click here.)

Review Date: August 24, 2004

Reviewed By: Jacqueline A. Hart, M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor, A.D.A.M., Inc.

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