How Do Fibrates Work?

Fibrates reduce the production of triglycerides and can increase HDL cholesterol. Examples of fibrates include:

Atromid

Tricor

Lopid

Ezetimibe lowers bad LDL cholesterol by blocking cholesterol absorption in the intestine. Research studies have not found that ezetimibe is associated with a lower risk of heart disease.

Are There Foods or Other Drugs I Should Avoid While Taking Cholesterol-Lowering Medicine?

You should limit grapefruit juice and fresh grapefruit consumption while taking statins, as grapefruit can interfere with the liver's ability to metabolize these medications. Talk with your doctor about your other medications, as it may be appropriate to adjust the dosing of your cholesterol medication depending on interactions.

Supplements for Lowering Cholesterol

Some of the herbal and nutritional supplements that may lower cholesterol include:

Garlic: According to some studies, garlic may decrease blood levels of total cholesterol by a few percentage points. Other studies, however, suggest that it may not be as beneficial as once thought. It may also have significant side effects and/or interaction with certain medications. Garlic may prolong bleeding and blood clotting time, so garlic and garlic supplements should not be taken prior to surgery or with blood-thinning drugs such as Coumadin.

Guggulipid: Guggulipid is the gum resin of the mukul myrrh tree. In clinical studies performed in India, guggulipid significantly reduced blood levels of total cholesterol and LDL cholesterol. The enthusiasm for using guggulipid as a cholesterol-lowering herbal agent, however, diminished after the publication of negative results from a clinical trial in the U.S. Further research is necessary to determine the safety and efficacy of this herb.

Red yeast rice: Red yeast rice has been found to lower cholesterol in studies and was previously found in the over-the-counter supplement Cholestin. However, in 2001, FDA took Cholestin off the shelf because it contained lovastatin, a compound found in the cholesterol prescription medication Mevacor. Reformulated "Cholestin" no longer contains red yeast rice. Other red yeast rice-containing supplements currently available in the U.S. contain very small amounts of lovastatin. Their effectiveness is questionable.

Policosanol: Produced from sugar cane, policosanol was found to be effective in lowering LDL cholesterol in several studies. Most policosanol supplements found in the U.S., including the reformulated Cholestin, contain policosanol extracted from beeswax and not the sugar cane policosanol. There is no evidence that policosanol extracted from beeswax can lower cholesterol. Additional studies on sugar cane policosanol are needed to determine its effectiveness in lowering cholesterol.

Other herbal products: The results of several studies suggest fenugreek seeds and leaves, artichoke leaf extract, yarrow, and holy basil all may help lower cholesterol. These and other commonly used herbs and spices -- including ginger, turmeric, and rosemary -- are being investigated for their potential beneficial effects relating to coronary disease prevention.

Dietary Approaches to Lowering Cholesterol continued...

Dietary fiber, soybeans, and phytosterols decrease cholesterol levels by different mechanisms. Therefore, it is not surprising that the combined dietary intake of these foods and other plant substances, along with a low intake of saturated fats, is more effective at reducing cholesterol levels than each individual substance alone.

High Cholesterol: Healthy Choices When Eating Out

Many restaurants offer delicious, low-fat, low-cholesterol meals. These tips will help you make eating out healthy and enjoyable.

Before You Order

If you are familiar with the menu, decide what to order before entering the restaurant. This tactic will help you avoid any tempting foods that may not be as healthy.

If you are trying a new restaurant, take time to study the menu in order to avoid making unhealthy decisions.

Have the server remove temptations (such as the breadbasket) from the table.

Drink two full glasses of water before your food arrives.

Avoid foods described in the following way: buttery, buttered, fried, pan-fried, creamed, escalloped, au gratin (with cheese), or a la mode (with ice cream).

If you do eat bread before your meal, choose Melba toast or whole-grain rolls without butter or margarine.

When You Order

Order foods that are steamed, broiled, grilled, stir-fried, or roasted.

Order potatoes baked, boiled, or roasted instead of fried. Ask the server to leave off the butter and sour cream.

Order first so that you will not be influenced by other's choices.

For appetizers, order broth-based soups such as minestrone or gazpacho instead of creamy soups or fried finger foods.

Choose seafood, chicken, or lean red meat rather than fatty or processed meats; remove all visible fat from any meat.

Ask for steamed vegetables instead of fries.

Ask for the sauces and dressings on the side so you can control how much you eat.

Ask the server about ingredients or preparation methods for the dishes you're not familiar with.

For dessert, order sorbet or fresh, seasonal fruit without whipped cream or a topping.

Salad Tips

When choosing from a salad bar, avoid items like grated cheese, potato salads, cream dressings, bacon bits, and croutons.

Use a squeeze of lemon instead of dressing on salads. Or try rice vinegar or balsamic vinegar.

If you opt for dressing on your salad, order the dressing on the side. Dip your salad fork into the dressing, then into the salad. You will consume less dressing if you just get a taste of it on each mouthful of salad rather than pouring it over the salad.

How High Cholesterol Leads to Atherosclerosis

Abnormal cholesterol levels are associated with clogged arteries as a result of a process called atherosclerosis. having a better cholesterol profile lowers the risk of diseases caused by atherosclerosis, like heart attacks and strokes. So what makes cholesterol so bad for your arteries? And isn't there a "good" cholesterol? How does treating high cholesterol help?

 

Your body makes cholesterol, and you also get it when you eat eggs, meats, and dairy products. When you have more than your body needs, cholesterol can cause plaque to build up in your arteries. This thick, hard plaque can clog your arteries like a blocked pipe. Reduced blood flow can lead to a stroke or heart attack.

How High Cholesterol Causes Heart Attack: If there is a clog in a coronary artery, your heart gets too little blood and oxygen. Without enough oxygen, your heart becomes weak and damaged. If the plaque breaks open, a blood clot may form on top of the buildup, further blocking blood flow. Or, a blood clot can break off and flow to an artery in another part of the body. If a clot completely blocks an artery feeding your heart, you have a heart attack.

How High Cholesterol Causes Stroke: Plaque buildup can also keep your brain from getting enough blood and oxygen. If a clot completely blocks an artery feeding your brain, you have a stroke.

Protect Yourself

You can outsmart high cholesterol. Eat a healthy diet, exercise, and take medicine as your doctor recommends to lower your levels.

The first step: Ask your doctor if it’s time for you to have a fasting cholesterol blood test. If they're high, ask your doctor what numbers are ideal for you based on your personal health and risk factors. Also ask how often you need the test.

Most people should have:

LDL, “bad” cholesterol, less than 100 mg/dL. If you already have heart disease, you may need to aim for under 70 mg/dL.

HDL, “good” cholesterol, 60 mg/dL or higher

Triglycerides, another type of risky fat in your bloodstream, less than 150 mg/dL