Check out the new kid on the block for hyperlipidemia treatment.
High cholesterol, or hyperlipidemia, isn’t exactly a disease itself. In fact, you can have high cholesterol and not even know it, since it doesn’t actually cause symptoms. However, high cholesterol requires treatment because it’s a major risk factor for cardiovascular diseases, heart attack, and stroke.
“We have several different ways to treat high cholesterol, depending on a person's cholesterol level [and] the side effect profile that we're looking for,” says Michelle W. Bloom, MD, hematologist and oncologist at Stony Brook Medicine.
Not all people with high cholesterol will need medications. For some people, lifestyle changes can lower cholesterol levels naturally. However, if cholesterol levels are dangerously high, or if lifestyle changes don’t lower levels enough, a doctor may recommend medications.
The most common prescription for high cholesterol is a class of medications called statins. “Statins work mainly by decreasing the body's production of cholesterol, but also helping the liver to clear cholesterol from our bodies,” says Dr. Bloom. Learn more about how statins treat high cholesterol here.
Newer Treatment Options for Hyperlipidemia
One of the newer options available for people with high cholesterol is called a PCSK9 inhibitor, or “proprotein convertase subtilisin/kexin type 9” inhibitor. These have been shown to effectively lower cholesterol levels and reduce the risks of stroke or heart attack.
PCSK9 is a protein in the body (made by the PCSK9 gene) that helps regulate cholesterol in the bloodstream, so it’s a great thing to target if you want to bring down cholesterol levels. “PCSK9 inhibitors block this protein and therefore allow the liver to do its job at sweeping away excess cholesterol in the body,” says Dr. Bloom.
Instead of a pill, PCSK9 inhibitors are given via injection every few weeks, depending on the type. PCSK9 inhibitors are sometimes used in combination with statins.
Regardless of which medication you choose, it’s important to understand your prescription before you start taking it, and to continue making healthy lifestyle choices. Your medication will always be more successful in combination with a healthy diet, an active lifestyle, and other heart-healthy habits.
Dr. Bloom is an associate professor of medicine at Stony Brook University Medical Center, a fellow of the American College of Cardiology, and a fellow of the Heart Failure Society of America.
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We have several different ways to treat high cholesterol,
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depending on a person's cholesterol level and also
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depending on the side effect profile that we're looking for.
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Cholesterol is a waxy, fat-like substance, and it's actually
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a necessary building block to make cells healthy.
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When cholesterol levels get too high, those levels
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can actually cause cholesterol plaques
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to deposit in the arteries of our body.
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The most commonly prescribed medications
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are called statins.
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Statins work mainly by decreasing the body's production
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of cholesterol, but also helping the liver
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to clear cholesterol from our bodies.
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There are newer medications called PCSK9 inhibitors.
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There's a protein circulating in the body called PCSK9.
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PCSK9 inhibitors block this protein and therefore allow
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the liver to do its job at sweeping away
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excess cholesterol in the body.
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They're actually given by injection rather than
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in the form of a pill, and they are injections that are given
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every few weeks, depending on which type you use.
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I always say to patients, the most important thing
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is that before you take a medication, you need
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to understand what the medication is being used for,
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and why you need to take it, and also
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what the potential side effects are of those medications,
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so that you know what types of things to look for,
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and that way doctors can know to adjust the medication
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accordingly, or maybe to switch you to a different type
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of medication that can accomplish the same thing.
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Even if we are going to use medications to treat cholesterol,
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healthy lifestyle, diet, weight loss, and all of that
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is so critically important to the overall treatment plan
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in a high cholesterol state that we cannot forget about that.
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Cholesterol medications. Dallas, TX: American Heart Association. (Accessed on February 11, 2020 at https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia/cholesterol-medications.)
Control your cholesterol. Dallas, TX: American Heart Association. (Accessed on February 11, 2020 at https://www.heart.org/en/health-topics/cholesterol/about-cholesterol.)
PCSK9 gene. Washington, DC: Genetics Home Reference, U.S. National Library of Medicine. (Accessed on February 11, 2020 at https://ghr.nlm.nih.gov/gene/PCSK9.)PCSK9 inhibitors: pharmacology, adverse effects, and use. Waltham, MA: UpToDate, 2020. (Accessed on February 11, 2020 at https://www.uptodate.com/contents/pcsk9-inhibitors-pharmacology-adverse-effects-and-use.)