The Centers for Disease Control and Prevention reports that one in every six adults suffers from high blood cholesterol levels, which remains a significant risk factor for heart disease, the No. 1 cause of death in the United States. Although doctors encourage patients to make lifestyle changes to reduce their cholesterol levels, some require the help of medications. Although effective in lowering low-density lipoprotein, or LDL, the bad cholesterol, the class of drugs called statins can cause many side effects, leaving patients searching for alternatives.
Problems With Statins
Statin medications, also known as HMG-CoA reductase inhibitors, work by inhibiting the actions of an enzyme needed by liver cells to produce cholesterol. This significantly reduces the amount of cholesterol produced within the body. Since 75 percent of your total cholesterol comes from internal production, blocking internal production significantly decreases both total blood cholesterol levels and LDL cholesterol levels. The effectiveness of statin medications vary, but on average, statins like simvastatin and atorvastatin lower LDL levels by 35 to 38 percent, according to "American Family Physician." The dramatic reduction in cholesterol levels can cause significant health problems, including liver damage and muscle problems. Some patients suffer from rhabdomyolosis, the breakdown of muscle cells, which causes kidney damage.
Bile Acid Sequestrants
Bile acid sequestrants, including colesevelam, cholestyramine and colestipol, work in the intestines to prevent the breakdown and absorption of fats and cholesterol. These medications help to lower LDL cholesterol levels since 25 percent of your total cholesterol comes from the foods you eat. Taking a bile acid sequestrant allows the cholesterol and fat from food to get excreted without getting into the blood.
Ezetimibe
Ezetimibe is another medication that inhibits the absorption of cholesterol in the intestines. By inhibiting the absorption of cholesterol, ezetimibe effectively reduces total cholesterol and LDL cholesterol levels. Doctors often prescribe ezetimibe along with a statin medication, as the combination can lower LDL cholesterol by an additional 15 to 20 percent over a statin medication alone, according to MayoClinic.com.
Fibrates
The class of drugs known as fibrates, which includes the drugs gemfibrozil, fenofibrate and clofibrate, can lower cholesterol levels by stimulating the oxidation, or breakdown, of fatty acids. Fibrates produce the largest effect on triglyceride levels, another type of fat that contributes to heart disease. Fibrates can also help to increase HDL, or good cholesterol, levels, but can produce mild effects on reducing LDL cholesterol levels.
Niacin
Niacin, also known as nicotinic acid or vitamin B-3, is also effective in treating high blood cholesterol levels. Doctors must prescribe the prescription form of this medication, and you should not substitute the prescription medication for an over-the-counter dietary supplement that contains niacin. Niacin effectively lowers triglyceride levels, and when prescribed with a bile acid sequestrant, the combination significantly reduces LDL cholesterol levels, according to the American Heart Association.
References
- Centers for Disease Control and Prevention; High Cholesterol; February 2011
- "American Family Physician"; Effective Use of Statins to Prevent Coronary Heart Disease; Michael Crouch; January 2001
- MayoClinic.com; Statins: Are These Cholesterol-Lowering Drugs Right for You?; February 2010
- "Cellular Molecular Life Science"; Lipid-Lowering Drugs; K. Pahan; May 2006
- American Heart Association; Cholesterol-Lowering Medications; April 2009
