Statins are one—but not the only—treatment for high cholesterol.
When it comes to treatments to lower cholesterol, statins are the most common option. Statins work very well to lower cholesterol numbers, reduce the risk of heart attack and stroke, and don’t cause a lot of side effects. When statins aren’t the right fit for you, your doctor might suggest new cholesterol treatment options.
Is Your Statin Working?
It’s rare that statins “wouldn’t work” for you. Almost everyone who uses a statin sees their cholesterol numbers go down at least a little. The question is whether or not a statin is working enough to lower your risk of heart attack, stroke, or heart disease.
You can see if your statin is working by getting a blood test at your doctor’s office. Based on the results and your other risk factors, your doctor might want to:
- Adjust your dose: People who have more risk factors for heart problems often need a higher dose of a statin.
- Change to a different statin: There are many different statins that work in slightly different ways. One statin may work better for you than another. Your doctor may try a second statin if the first isn't a good fit.
- Switch to a new or different cholesterol treatment: You might have better results from a different type of cholesterol medicine.
Other Treatments to Lower Cholesterol
One of the other treatment to lower cholesterol is a class called PCSK9 inhibitors. These work by helping your liver clear out the LDL (“bad”) cholesterol from your body.
Like statins, PCSK9 inhibitors can both lower your cholesterol numbers and reduce your chances of heart problems. This makes them a great alternative to statins when needed. However, they are an injection, and they can be expensive. That’s why they continue to be a second-line cholesterol treatment, behind statins.
Next, there’s another new cholesterol treatment that you take with a statin. These are called cholesterol absorption inhibitors. This medicine works in the gut and helps your cells release the cholesterol. These medicines don’t reduce the risk of heart disease on their own, but they can help your statin work better.
Finally, another cholesterol treatment is a highly purified form of fish oil. It’s not the same as the fish oil you would find over-the-counter in the store. This treatment is for a specific group of people who:
- Have many risk factors for heart problems
- Already take a statin
- Still have high triglyceride levels
The Right Treatment for You
You and your doctor will work together to find the cholesterol treatment that helps you the most. The right treatment will not only lower your cholesterol numbers, but also your risk for heart attack and stroke.
Dr. Tolani is a cardiologist at Columbia University Irving Medical Center.