The new cholesterol guidelines designed to decrease LDL (bad) cholesterol levels were recently issued by the American Heart Association (AHA). The cholesterol guidelines were last revised in 2013. In addition, these new guidelines have also been approved by the American Diabetes Association.
New Cholesterol Guidelines: What Are They?
Of course, a healthy diet and regular physical activity are a must for all age groups to prevent cardiovascular disease and high cholesterol.
However, if cardiovascular disease in the form of plaque in the arteries is found, high intensity statin therapy is recommended.
Statins are a group of drugs that reduce levels of fats, including triglycerides and cholesterol, in the blood. They work by reducing the liver’s production of cholesterol. They block an enzyme called HMG CoA Reductase that the liver uses to make cholesterol.
The goal is to lower LDL (bad cholesterol) by 50% or more.
Statin drugs approved in the United States to lower bad cholesterol levels are:
- atorvastatin (Lipitor),
- fluvastatin (Lescol, Lescol XL),
- lovastatin (Mevacor, Altoprev),
- pravastatin (Pravachol),
- rosuvastatin (Crestor),
- simvastatin (Zocor), and.
- pitavastatin (Livalo).
In these new guidelines, specific LDL levels are specified. The goal is to reach and maintain a target LDL-C of 70 mg/dl.
Furthermore, if the statin drugs do not lower LDL scores to acceptable levels, physicians can add the drug ezetimibe, which prevents absorption of cholesterol in the intestine.
Doctors can also prescribe PCSK9 inhibitors. These inhibitors are proteins made in a laboratory. They target other proteins in the liver. specifically your liver.
Liver cells have receptors that sweep away excess cholesterol. But another protein called PCSK9 destroys these good liver cell receptors. The PCSK9 inhibitor blocks the PCSK9 and prevents them from acting. The results is a lowering of LDL levels in the blood.
Studies show that PCSK9 inhibitors can reduce LDL levels by 47% and reduce heart attacks by 27%.
New Cholesterol Guidelines: More Guidelines
Statins are definitely recommended for patients with cardio risk factors such as smoking, high blood pressure, and diabetes. A family history of cardiovascular disease would also recommend statin therapy.
Statins do have side effects. The most common ones are:
- Difficulty sleeping.
- Flushing of the skin.
- Muscle aches, tenderness, or weakness (myalgia)
- Nausea or vomiting.
- Abdominal cramping or pain.
For patients who can not handle statin medications, lower dosages and /or lifestyle changes may still be effective.