Alternative Treatments Exist Besides Statins for Managing High Cholesterol Levels
In the quest to maintain heart health, managing cholesterol levels is crucial. Here's a rundown of various methods and medications that can aid in this endeavor.
Firstly, let's discuss medications. Nexlizet, a combination of bempedoic acid and ezetimibe, is a notable option. This drug is used to reduce the risk of heart attacks and the need for heart surgery in people with heart disease who can't take statins. Bempedoic acid, an ATP citrate lyase inhibitor, has also been approved for the treatment of patients with atherosclerotic cardiovascular disease or familial hypercholesterolemia. In 2024, the FDA expanded its approval to reduce the risk of cardiovascular events and lower LDL cholesterol levels.
Another medication, ezetimibe, is a cholesterol absorption inhibitor that prevents the small intestine from absorbing cholesterol. Sequestrants, such as cholestyramine, colestipol, and colesevelam, work by binding to bile in the intestines, blocking cholesterol absorption into the bloodstream.
For those with high triglycerides, fibrates are prescribed for more aggressive treatment. Niacin, a common prescription, can lower bad cholesterol (LDL) and increase good cholesterol (HDL). However, side effects may include flushing of the face, nausea and/or vomiting, rash, low blood pressure, elevated blood uric acid level, and pins and needle sensation.
PCSK9 inhibitors, such as Alirocumab (Praluent), evolocumab (Repatha), and inclisiran (Leqvio), serve as an alternative for people who cannot take statins or have very high cholesterol levels. These drugs regulate the number of low-density lipoprotein (LDL) receptors in the body, thereby affecting LDL cholesterol levels.
Beyond medication, lifestyle changes play a significant role in managing cholesterol levels. Exercise is a key factor in lowering high cholesterol and offers numerous other health benefits. Managing weight and eating heart-healthy foods is also essential. Eating a heart-healthy diet means decreasing the amount of saturated (animal) fat and increasing fiber, fruits, vegetables, whole grains, and fish.
Interestingly, dietary supplements of omega-3 fatty acids, found in fish oil, can reduce triglyceride levels. Natural remedies, such as certain herbs and supplements, may complement cholesterol-lowering efforts, but should always be used in addition to lifestyle changes and prescribed medications.
Lastly, it's worth noting that losing as little as 5 to 10 pounds can help reduce cholesterol levels. By adopting a combination of these strategies, individuals can significantly improve their heart health and reduce the risk of cardiovascular events.
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