Introduction

Cholesterol is perhaps one of the most talked about health issue today. While the name "cholesterol" has been linked with bad health and targeted as something that should be eliminated, cholesterol actually serves a vital roll in the body's makeup and in your body's metabolism processes.

Cholesterol is used by the body to fuel cell growth and regeneration. To accomplish this the body harvests cholesterol from foods that are eaten, and from stores of cholesterol that the body produces in the liver. In general, the body really only needs a small amount of cholesterol to meet all of its cholesterol needs, however, because cholesterol is found in a wide variety of favorite foods, an excess of cholesterol is easy to attain. If too much cholesterol enters the bloodstream then a condition known as hypercholesterolemiahypercholesterolemia develops which increases the chances that a person will develop health threatening conditions such as heart disease, heart attack, or stroke.

There are three types of cholesterol: low-density lipoprotein (also referred to as LDLs), high-density lipoproteins (also referred to as HDLs), and triglycerides. As you probably have heard not all cholesterol is bad, and in fact high levels of the second kind of cholesterol, high-density lipoproteins, is actually a very good thing and it is a good way to prevent heart disease. On the other hand, the other two types of cholesterol, low-density lipoproteins and triglycerides are both hazardous to your health if they are found in high levels in your blood. High levels of LDLs in the blood increases your chances of developing heart disease, and high levels of triglyceride, which is stored in the body as fat, can also increase the chances that heart disease will develop.

High cholesterol is caused by a number of factors including heredity, diet, age, gender, other preexisting medical conditions, and the amount of exercise you get. To reduce the amount of bad cholesterol that is floating around and accumulating in your body you can adopt several different strategies. The first strategy is to change your diet by reducing the amount of cholesterol, calories, and saturated fat that make up your daily food intake. The second strategy is to increase the amount of exercise that you participate in each day. Exercise can be use to burn off, if you will, excess cholesterol and help you to reduce your bad cholesterol levels. If you have tried to lower your bad cholesterol levels through diet and exercise and you still are not seeing the kind of results that you want, you may need to treat your high cholesterol with drugs.

Drug Treatments

Doctors don't just start you on drugs to treat your high cholesterol simply because you have high cholesterol, instead they evaluate your total health and determine if your cholesterol levels, heart disease proneness, and other risk factors warrant drug therapy interventions. However, if it is determined that your condition warrants a drug therapy intervention, then you will be prescribed a drug from HMG-CoA Reductase Inhibitor, Bile Acid Resins, or Fibric Acid Derivatives drug groups.

HMG-CoA

The most common drug prescribed to treat high cholesterol levels in the blood, or hypercholesterolemiahypercholesterolemia, are HMG-CoA reductase inhibitors (statins). This class of drugs is used because they are effective at lowering LDL levels without many side effects. Drugs that fall into this class include:

• Altocor
• Altoprev
• Baycol (which is no longer on the market)
• Crestor
• Lescol
• Lescol XL
• Lipitor
• Mevacor
• Prevachol
• Zocor

HMG-CoA reductase inhibitors work by inhibiting the body's natural chemical process of creating cholesterol in the liver. By inhibiting this process the overall amount of bad cholesterol in the bloodstream is reduced and your cholesterol levels are then only impacted by the physical amount of cholesterol that is ingested. As this amount can be controlled through adjustments to one's diet, the HMG-CoA reductase inhibitors are really only used to help manage those cholesterol levels that the body creates which are not controllable through diet.

If you are prescribed an HMG-CoA reductase inhibitor, also known as a statin, then you will be required to take one dose of the drug each day. The milligram dosage will depend on your individual cholesterol reduction needs, as well as the brand name of the statin that you have been prescribed. For example, Crestor has a recommended dosage level between 5 and 40 mg and has the ability to lower your LDL levels by 45-63%, while Lescol has a recommended dosage of 20-80mg with a potential to only lower your LDL levels by 22-36%. This shows that the brand name, or statin class, that you are prescribed will depend on how much you need to lower your LDL levels.

You should also be aware that some drugs will interact severely with HMG-CoA reductase inhibitors. If you take antacids, cyclosporine, erythomycin, gemfibrozil, niacin, or warfarin, then you should consult with your doctor about possible side effects and negative interactions that these drugs could have with your high cholesterol drug treatment(s), and ask your physician or health care professional if there are warning signs that you should look for.

Other things that you should avoid while taking an HMG-CoA reductase inhibitor are grapefruit and grapefruit juice. The chemicals found in the grapefruit reduce the body's ability to eliminate statins from the bloodstream, and if you eat grapefruit or drink grapefruit juice regularly while you are taking an HMG-CoA reductase inhibitor, then a toxic build up of this drug could occur. This build up can lead to medical complications that could threaten your health.

Bile Acid Resins

While slightly disgusting sounding, bile is a very important compound that is found naturally in the body that is used to break down and digest fats in the body. Like cholesterol, bile is manufactured in the liver. Once manufactured bile then travels to the gallbladder where it is stored for later use. After food is processed in the stomach and travels to the small intestines, the gallbladder contracts and expels a small amount of bile into the small intestine which is then used to both digest dietary fats and to flush the digested fats through the digestive system. As the bile/fat molecules travel through the small intestines they are reabsorbed into the bloodstream through the walls of the small intestine and then they travel to the liver where the bile is recycled and the fat is stored.

Bile acid resins sponge up bile acid in the small intestine and prohibit their re-absorption and the recycling of the bile by the body. As a result of this absorption of bile in the small intestines, the liver is forced to produce more bile. The benefit of using bile acid resins is therefore that they force the liver to use cholesterol in order to produce more bile. This helps reduce the total amount of cholesterol that is stored in the body and thus your total cholesterol levels are reduced.

This particular high cholesterol drug treatment class is most effective in treating moderately elevated LDL levels. Drugs from the bile acid resin family include:

• Colestid
• Prevalite
• Questran
• Questran Lite
• Welchol

The most common drug interaction that is associated with bile acid resins is that they have a tendency to bind with most oral medication. This binding characteristic increases the amount of time it will take for the body to absorb your other oral medications, and it may reduce their effectiveness. Other complaints that have been noted with this class of drugs include digestive tract irritation, chest pain, rashes, swelling of the extremities, and headaches. While there is a list of possible side effects and drug interactions, the severity of such interactions and side effects are really only result in mild discomfort.

Fibric Acid Derivatives

The final class of drugs that are used to treat high cholesterol are fibric acid derivatives, also known as fibrates. It really isn't known how this group of drugs works to lower cholesterol levels, but it is assumed that they promote the breakdown of triglycerides, inhibit the body's ability to produce cholesterol, and finally act as a diuretic mechanism that helps to rid the body of cholesterol molecules. Fibrates are most effective at reducing triglyceride levels, however, they are not effective for lowering LDL levels. Because of this these drugs are not usually used alone, but are instead used in conjunction with other cholesterol lowering devises and treatment plans and drugs to produce the bests results.

There are several drugs that are found in this drug class including:

• Clofibrate
• Fenofibrate Capsules
• Fenofibrate Tablets
• Gemfibrozil
• Lopid

Unlike HMG-CoA reductase inhibitors, fibric acid derivatives are taken either twice a day or once a day depending on the brand name of the fibrate. Lopid is usually taken twice a day, whereas Fenofibrate is usually only taken once a day.

People who take fibrates should be aware of the negative drug interaction that can occur when statins and fibrates are taken in conjunction with each other. A condition known as rhabdomyolysisrhabdomyolysis may develop when these two drugs are taken together. This condition attacks and damages muscle cells, which then release their contents into the blood stream and in turn cause damage to the body's organs. If you are taking both of these types of cholesterol lowering drugs you will need to be monitored for this condition as well as be monitored for organ damage.

Other side effects that you should be aware of are similar to those created by other cholesterol treatments. It is common to experience digestive tract irritation, stomach pain, nausea, and bloating.

How to Choose the Best High Cholesterol Treatment

Your best ally in selecting the high cholesterol treatment plan for you is education. Arm yourself with as much information about cholesterol and cholesterol treatment as you can, as well as increasing your knowledge of how your body works. This information will help you to not only make the best medical judgments that you can when offered a choice between treatment options, it will also help you understand what your doctor is telling you and help you to determine if the plan that they are offering you is the right one for you. You know your body better than any one else, so you should be the one who directs what treatment paths that you take. By arming yourself with information about your body and condition, you will be able to help develop a treatment plan that will work the best for you.