Drugs to Lower Cholesterol Levels

Of course, not everyone has the discipline to change a lifestyle so completely that they can lower their cholesterol levels as far as they need. And for some people, born with the tendency to a high blood cholesterol, it remains high even if they adhere very strictly to a low-fat lifestyle. For them the only answer is to take cholesterol-lowering drugs.

Trials reported in the mid-1990s all showed that the newest of this class of drugs, the 'statins', both reduce cholesterol levels and consistently prevent heart attacks and strokes - lowering their rates by around a third. The authorities on cholesterol, the British Hyperlipidaemia Association (BHA) and the European Atheroscle­rosis Society (EAS), have come to a consensus on what doctors should do about patients with high cholesterol levels.

The desirable total cholesterol (TC) level is no more than 5.2 mmol/1 of blood. Within this figure the 'low density lipoprotein cholesterol' (LDL) level should be no more than 3.5 mmol/1 if the person possesses other risk factors for heart disease such as high blood pressure or smokes. The BHA and EAC counsel doctors to treat people with TC levels between 5.2 and 6.5 mmol/1 with weight reduction, a diet low in saturated fat and cholesterol, and high in fibre. Those with TC levels between 6.5 and 7.8 mmol/1 should have a rigorous trial of diet, but be switched to drugs if they do not respond with a steep drop in TC. People with TCs above 7.8 mmol/1 should be treated with both diet and drugs. These people may need two drugs of different types to lower their cholesterol levels satisfactorily.

According to the trial results, the most effective group of cholesterol-lowering drugs is the 'statins'. They include atorvastatin, cerivastatin, fluvastatin, pravastatin and simvastatin. They are not all exactly alike: they have different doses and different side-effects, so that one statin may suit one person better than another. The commonest side-effect is muscle pain, although this seems to be less severe with the newer drugs, such as atorvastatin.

As anyone reading this far will already have realized, however, cholesterol alone is only part of the story. It cannot be taken in isolation from smoking, exercise and blood pressure - and alcohol - consumption has also to be considered.