Conditions in Depth

This page contains the basic information about High Cholesterol (Hypercholesterolemia) .

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High Cholesterol (Hypercholesterolemia)

Treatment

You can treat high cholesterol by eating a low-fat, low-cholesterol diet and by taking medications to lower cholesterol. The specific treatment plan will depend on your cholesterol level (including LDL cholesterol) and on your history of coronary artery disease or risk factors for coronary artery disease.

Diet

The National Cholesterol Education Program recommends the following diet:

• Saturated fat—less than 7% of calories

• Monounsaturated fat—about 20% of calories

• Polyunsaturated fat—about 10% of calories

• Protein—about 15% of calories

• Carbohydrates—about 50% of calories

• Fiber—about 25 grams per day

• Cholesterol—less than 200 milligrams per day

Avoid all trans fats.

To maintain a desirable weight, you should take in only as many calories as you burn each day. If you need to lose weight, you need to take in fewer calories than you burn.

People who aren't sure how to follow such a diet may find it useful to work with a health care professional such as a dietitian, nutritionist, doctor or nurse.

Medications

There are five types of cholesterol-lowering medications:

• Bile acid-binding resins, including cholestyramine (Questran) and colestipol (Colestid). They are used less often today because they lower HDL (good) cholesterol as well as LDL (bad) cholesterol.

• Niacin (several brand names).

• Fibrates, including gemfibrozil (Lopid), fenofibrate (Tricor) and clofibrate (Abitrate). Fibrates are especially helpful for people with high triglyceride levels.

• Statins, also called HMG-CoA reductase inhibitors, including lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), fluvastatin (Lescol), atorvastatin (Lipitor), and rosuvastatin (Crestor). Statins block an enzyme called HMG-CoA reductase, which is necessary for the production of cholesterol. They are the most commonly prescribed cholesterol lowering medication.

• Selective inhibitors of intestinal cholesterol absorption—There is only one available, ezetimibe (Zetia).

If your cholesterol is not controlled with diet and other lifestyle changes, your doctor may recommend that you take one or more of these medications. Each type of medication works differently and has different types of side effects.

In addition to dietary changes or medication, people with high cholesterol should try to control their other risk factors for coronary artery disease. This means keeping blood pressure at normal levels, not smoking, controlling your blood sugar, maintaining or losing weight and following a regular exercise schedule.