How to Lower Blood Cholesterol Fast? Top Harvard Cardiologist’s Advice (6)
21
September

By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , , , /


– How to lower cholesterol?
Dr. Anton Titov MD Let’s discuss treatment of high cholesterol. High cholesterol level is a major risk factor
for coronary heart disease. Recently the clinical guidelines for use of
statins have changed. Statins are major drugs to lower cholesterol. Revision of statin use guidelines generated
controversy in medical community. Under the new guidelines a number of people
who should use statins to lower cholesterol have increased. But many people do not make full use of non-pharmacologic
methods for lower cholesterol: the lifestyle changes, better food, and dietary changes. How do you approach the management of risk
factors for coronary heart disease in your practice? Since early 1980s we have learned that LDL
cholesterol is the bad cholesterol Any lifestyle modifications and any medications that specifically
lower the level of LDL cholesterol – almost always there is a benefit to the patient. It seems that the lower you make LDL cholesterol
level – the lower the risk of coronary artery disease. Can LDL cholesterol be too low? If LDL cholesterol is too low – can this create
a problem? This has been a controversial issue. Probably too low level of LDL cholesterol
is not really in issue for most people. We are not so worried that LDL cholesterol
is going to be too low. For patients who do not have very high risks
for coronary heart disease, we would love to see them work on improving their lifestyle. No questions about that. Who has low risk profile for coronary heart
disease? #1: Those people who do not have a family
history of very premature coronary artery disease. #2: Those who do not have diabetes. #3: Those who never had any heart-related
health event whatsoever. But lifestyle change is a tough proposition. Relatively few people can keep their weight
just where it should be. Few people can exercise on a regular basis
and have very good diet. Let’s now look at people who have already
had a heart-related health problem, who have diabetes, who have a strong family history
of premature coronary artery disease. In my clinical practice I support healthy
diet and lifestyle changes. This is all terrific. But diet and lifestyle lowers LDL cholesterol
in these people by only about 5%. Medications, the statins, often lower cholesterol
by 20% to 40%. Medications and lifestyle / dietary changes
are synergistic. So it’s wonderful to put them together. So I say to my patients: “Let’s make it very
low. Let’s drive it down.” The recent clinical guidelines on the use
of statins to lower cholesterol are controversial in several areas. One controversy is about the dose of statins
to treat patients. Also there is controversy about evidence Dr.
Dale Adler, MD: I agree very much with the guidelines when they say: “If you’re going
to use the statin to lower cholesterol, use statin in a dose that was used in the clinical
trial”. For example, simvastatin is a very nice medication
to lower cholesterol. In the clinical trials simvastatin was used
at 40 milligrams But a lot of physicians prescribe simvastatin at 5 milligrams or 10 milligrams
per day. I say: “If it’s worth treating a patient with
a statin medication, then start medication in a dose that was established and shown to
make a big difference.” If the patient has trouble tolerating statin
at that dose, then you may have to decrease the dose of medication. That even occurred in some of the clinical
trials.


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