1. Cholesterol Levels Slideshow Pictures
2. Lower Cholesterol Slideshow: Avoid Heart Disease
3. Take the Cholesterol Quiz

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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If following a low-saturated fat, low-cholesterol diet, increasing physical activity, and losing weight have not lowered the risk for developing coronary heart disease after about 3 months, your doctor may consider prescribing a cholesterol-lowering medication. If your doctor prescribes medicine, you must still:

1. follow your cholesterol-lowering diet;
2. be more physically active;
3. lose weight if you are overweight; and
4. control or stop all of your other coronary heart disease risk factors (including controlling high blood pressure and diabetes, and quit smoking).

Taking all these steps together may lessen the amount of medicine a person needs or make the medicine work better, which reduces the risk for developing coronary heart disease. The doctor may prescribe medication from the following categories:

Statins: Statins lower LDL cholesterol levels more than other type of drug. They lower cholesterol by slowing down the production of cholesterol and by increasing the liver's ability to remove the LDL cholesterol already in the blood.

• Studies using statins have reported 20%-60% lower LDL cholesterol levels in people taking them. Statins also reduce high triglyceride levels modestly, and produce a mild increase in HDL cholesterol.
• Results from statin medications are seen after several weeks. After 6-8 weeks, a patient's doctor may recheck blood tests. A second measurement of LDL cholesterol level must be averaged with the first to help adjust medication dosing.
• Statins are well tolerated, and serious side effects are rare. Rarely, widespread muscle breakdown, known as rhabdomyolysis, may occur. The symptoms include diffuse muscle pain, weakness, and dark colored urine. This may signal a medical emergency: if you develop these symptoms, stop taking the statin medication and contact your health care practitioner immediately.
• Other side effects may include an upset stomach, gas, constipation, and abdominal pain or cramps. These symptoms are usually mild to moderate and generally go away as your body adjusts to the medication.
• Monitoring of liver function by blood tests is usually ordered in patients taking statins.
• There are many statin drugs (available by prescription). The choice made by the health care practitioner and patient will depend upon the clinical situation. Examples include:
• atorvastatin (Lipitor),
• fluvastatin (Lescol),
• lovastatin (Mevacor, Altocor),
• pravastatin (Pravachol),
• simvastatin (Zocor), and
• rosuvastatin (Crestor).

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