Definition
In medical terms, the "high cholesterol" is called hypercholesterolemia: it is a pathological condition in which the levels of cholesterol in the blood are much higher than the norm (> 200mg / dl). Hypercholesterolemia is heavily influenced by the genetic component; therefore, the patients who are affected, already at a young age, tend to produce a quantity of cholesterol outside the norm.
Causes
Although many patients with high cholesterol are genetically predisposed, there are certainly cases in which hypercholesterolemia is linked to an unbalanced diet, rich in lipids and carbohydrates, obesity / overweight and a sedentary lifestyle.
- Risk factors: smoking (tends to decrease levels of "good cholesterol" (HDL) in the blood), diabetes (increases lipid mobilization), hypothyroidism (increases cholesterol levels), menopause (androgen increase)
Symptoms
High cholesterol, by itself, does not cause any symptoms: only blood tests can identify the disease with certainty. However, hypercholesterolemia increases the risk of cardiovascular disease, atherosclerosis, angina pectoris, ischemia, stroke.
Natural Care
Diet and Nutrition
Information on Hypercholesterolemia - Drugs for the Treatment of High Cholesterol is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Hypercholesterolemia - High Cholesterol Drugs.
drugs
High cholesterol - particularly when associated with diabetes, hypertension, obesity (metabolic syndrome) and smoking - increases the risk of cardiovascular disease exponentially; for this reason, the monitoring of cholesterol levels in the blood is one of the rules for the prevention of cardiovascular diseases, especially for patients who have a genetic predisposition to the disease, for the obese and for all individuals who have already suffered a cardiovascular event in the past .
The dietary correction approach is the most important preventive measure to escape hypercholesterolemia: it is recommended to reduce the intake of dietary cholesterol and saturated fats, as well as preferring healthy foods (such as cereals, legumes, vegetables, whole grain products) to hyperlipidic products (such as butter, dairy products, cheeses) and salt.
Clearly, a balanced diet is recommended to combine regular exercise.
The use of lipid-lowering drugs may be a possible option when the sport-related diet is not sufficient to keep blood cholesterol levels in balance; it should also be remembered that the administration of drugs must not replace either an ideal diet or sport, rather it must be a completion to them.
Fibrates : indicated for patients suffering from hypercholesterolemia who have high levels of triglycerides in the blood. They are widely used for the treatment of dysplidemias in general:
- Gemfibrozil (eg Lopid, Genlip, Gemfibrozil DOC): for the treatment of hypercholesterolemia, the recommended dosage is usually 600 mg of active, to be taken orally, twice a day, preferably 30 minutes before breakfast and dinner .
- Fenofibrate (eg Lipsin, Fulcro, Fenolibs, Lipofen): the dosage plans to take an active dose of 200 mg (1 capsule), once a day.
- Clofibrate (eg. Arterial, Clopir, Ellemger): indicatively, take 500 mg of drug, orally, 4 times a day.
It is recommended to always combine a balanced diet and constant physical exercise
Statins : block the enzyme HMG-CoA-reductase, useful for the synthesis of cholesterol; statins act with a dual mechanism of action: since they increase the synthesis of "good" cholesterol (HDL) and inhibit the production of bad endogenous cholesterol (LDL). They are the most prescribed drugs to treat high cholesterol. These active ingredients are also indicated to "absorb" the cholesterol deposited on the walls of the arteries, a useful feature to treat coronary heart disease in general.
- Atorvastatin (eg Totalip, Torvast, Xarator): this statin is probably the most used in therapy for the treatment of high cholesterol, along with simvastatin. In general, the initial dose varies from 10 to 40 mg per day, to be taken orally. The dose of 40 mg per day is indicated for patients requiring a reduction in bad cholesterol of more than 45%. Continue with this dosage for 2-4 weeks. The maintenance dose includes the intake of 10-80 mg of active per day. Consult your doctor.
- Lovastatin (eg Lovinacor, Tavacor, Rextat): start the treatment with a dose of 20 mg of drug, taken once a day, together with the meal. The maintenance dose is expected to take 10-80 mg a day, possibly divided into two doses. The drug is also available in the form of slow-release tablets: in this case, start the therapy with 20-40-60 mg of drug, to be taken once a day, before going to bed; patients who require a small reduction in bad cholesterol can take only 10 mg of drug per day. The maintenance dose varies from 10 to 60 mg a day, depending on the severity of the condition. The active ingredient is also available in association with niacin.
- Simvastatin (eg. Zocor, Simvastat, Omistat, Quibus, Setorilin). It is recommended to start the treatment with a dose of drug ranging from 10 to 20 mg, to be taken orally, once a day. The maintenance dose is expected to take 5-40 mg of active per day (once a day, in the evening). Sometimes the drug is formulated with other active ingredients, such as sitagliptin (eg Juvisync), useful for combating diabetes in the context of hypercholesterolemia, and ezetimibe (eg Vytorin).
- Fluvastatin (eg Lescol, Lipaxan, Primesin): start therapy with a variable dose of 20 to 40 mg a day, once a day, before going to bed. The maintenance dose varies from 20 to 80 mg a day.
- Pravastatin (eg. Selectin, Langiprav, Sanaprav). Indicatively, for the treatment of hypercholesterolemia, take the drug at a dose of 40 mg, orally, once a day. For the maintenance dose, it is possible to take 40-80 mg of the drug a day. Consult your doctor. The drug can also be formulated with other active ingredients, such as acetylsalicylic acid, antiplatelet agent: the two active exercise their therapeutic activity in synergy, both for the treatment of high cholesterol (pravastatin), and for treating and preventing ischemia and myocardial disorders (acetylsalicylic acid). Furthermore, pravastatin can also be found in combination with Fenofibrate (eg Pravafenix), as tablets composed of 40 mg of pravastatin and 160 mg of fenofibrate: in this case, it is recommended to take a drug tablet once a day, combining pharmacological treatment for a healthy diet and regular exercise.
Selective inhibitors of intestinal cholesterol absorption : drugs exert their therapeutic activity on biliary cholesterol and on that introduced with diet.
- Ezetimibe (eg Goltor, Inegy, Zeklen, Zetia): in general, for the treatment of high cholesterol, it is recommended to take the drug at a dose of 10 mg, with or without food, once a day. As mentioned above, the drug is also available in association with simvastatin (Vytorin).
Niacin: (high doses) often associated with statins (especially simvastatin). Niacin (eg Niaspan), given in high doses, increases HDL and decreases triglycerides and bad cholesterol. It is recommended to start therapy for hypercholesterolemia with 100 mg of drug, to be taken 3 times a day, with or without food. The maintenance dose involves taking 1-2 grams of the drug, 3 times a day, with or without food. Do not exceed 6 grams per day. It is recommended to follow a balanced diet and to practice constant exercise. As an alternative to niacin, it is possible to take Acipimox (eg Olbetam), at a dose of 250 mg, 2-3 times a day. Consult your doctor.
Bile sequestering acid resins : these drugs are useful for promoting fecal excretion of bile acids, therefore, at the intestinal level, they are able to reduce cholesterol reabsorption.
- Colestipol (eg Colestid): start the drug at a dose of 5 grams of granules per os, 1-2 times a day; alternatively, take 2 grams (tablets), 1-2 times a day. The maintenance dose for the treatment of hypercholesterolemia can be increased up to 2-5 grams per day, every 1-2 months.
- Cholestyramine (eg Questran): in general, it is recommended to start the treatment for high cholesterol with a dose of 4 grams, to be taken orally, twice a day. For the maintenance dose, it is recommended to administer 4 grams of the drug orally, 3 times a day, before meals. The dose must however be perfected by your doctor, based on the severity of the condition and the response to treatment.
- Colesevelam (eg. Cholestagel): take 4-6 tablets (625 mg) per day, preferably in conjunction with meals. If necessary, take the drug in divided doses during the 24 hours. The drug is also available in association with statins.
In addition to correcting eating habits, practicing sports and, when necessary, taking drugs, hypercholesterolemia patients should pay particular attention to all those risk factors involved in the manifestation of coronary heart disease; to do this, you need to maintain regular blood pressure, control your blood sugar, not smoke and, if necessary, reduce your weight.
