Treatment of elevated cholesterol and triglycerides

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The first and foremost method for the treatment of high cholesterol and triglyceride levels is through low-fat diet, exercise and weight loss. Dietary changes must involve low total fat, low dietary cholesterol, low saturated fat and high starch and fiber content. Physical activity or exercise must involve aerobic exercising at least for twenty minutes 3-5 times weekly, but in reality, exercising still more is also good. People suffering from obesity can lower their LDL and triglyceride content by weight loss significantly.

Cholesterol tests must be undertaken every three or six months along with these lifestyle modifications. If they do not seem fruitful or satisfactory enough to lower the cholesterol levels, medications must be considered. The following drugs are normally prescribed.

• Bile acid binding resins
These drugs namely Cholestyramine, cholestipol, etc help in preventing the cholesterol which is present in bile (digestive enzyme from gall bladder) from being reabsorbed back in the gut. It includes side effects like gallstones, and intestinal gas which limits the usage of these drugs. Besides, they can also reduce the absorption of other medication drugs taken into the gut and can also lead to vitamin deficiencies. At times, they can drastically increase the triglyceride content.

• Niacin
Niacin belongs to the Vitamin B complex. It represent vitamin B5. Large doses of niacin can lower LDL and boost up HDL levels. The mechanism of action of how this occurs is still unclear. It also involves side effects like skin flushing, severe itching, gastrointestinal disturbances, etc. Though niacin is effective to control cholesterol levels, its side effects undermine its usefulness.

• Fibric acid derivatives
Two main examples are Gemfibozil and clofibrate. The main advantage is that they reduce the triglyceride content. The reduction of LDL is modest comparatively. They also include side effects like gallstones and gastrointestinal disturbances.

• Statins
Statin-based Drugs includes lovastatin, pravastatin, simvastatin and atorvastatin. They hinder the activity of HMG-CoA reductase, the liver enzyme thus lowering the liver production of cholesterol. They lead to reduced LDL levels, triglycerides (modestly) and increased HDL levels (modestly). They seem to be well accepted by the community as compared to other drugs. But sometimes they can cause increased release of liver enzymes, which should be monitored constantly. There are cases of muscle disorders (myopathy) as side effects of statins. Rarely, these disorders may be severe. Myopathy is most likely to occur when statins are taken along with gemfibrozil.

Among these drugs, statins have been proved to be more effective. They can also be easily and better tolerated. In addition to these merits, research has proved that statins when aggressively used can in fact stop the succession to coronary heart diseases and hence can be used sometimes instead of angioplasty.