Materiały źródłowe

• #1 Prevention and Treatment of High Cholesterol (Hyperlipidemia) | American Heart Association

  https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia

  When it comes to cholesterol, it’s important to know your numbers. […] If you’re diagnosed with high cholesterol, your overall health and other risks such as smoking or high blood pressure will help guide treatment. […] The good news is that high cholesterol can be lowered, reducing the risk of heart disease and stroke. […] Often, changing behaviors can help bring your numbers into line. […] If lifestyle changes alone don’t improve your cholesterol levels, medication may be prescribed. […] From a dietary standpoint, the best way to lower your cholesterol is to reduce your intake of saturated fat and trans fat. […] A heart-healthy diet emphasizes fruits, vegetables, whole grains, poultry, fish, nuts and nontropical vegetable oils, while limiting red and processed meats, sodium and sugar-sweetened foods and beverages.

• #1 Hyperlipidemia (High Cholesterol): Levels, Causes, Symptoms & Diagnosis

  https://my.clevelandclinic.org/health/diseases/21656-hyperlipidemia

  Even children can get their blood checked for high cholesterol, especially if someone in the child’s family had a heart attack, stroke or high cholesterol. Children and young adults can get checked every five years. […] Once you reach middle age, you should have your cholesterol checked every year or two. Your healthcare provider can help you decide how often you should have a hyperlipidemia screening. […] Changes you make in your life can keep you from getting hyperlipidemia. Things you can do include: Stop smoking. Stay active instead of sitting too much. Keep your stress level down. Get the right amount of sleep. Eat healthy foods. Cut back on eating fatty meats. Don’t buy snacks that have trans fat on the label. Stay at a healthy weight. […] Although high cholesterol puts you at risk for heart attacks and stroke, you can protect yourself by living a healthier lifestyle and taking medicine if needed.

• #1 Treat and Manage High Cholesterol | Cholesterol | CDC

  https://www.cdc.gov/cholesterol/treatment/index.html

  High cholesterol often is treated and managed by a combination of adjusting certain lifestyle factors and taking cholesterol-lowering medicines prescribed by a doctor. […] You can take steps to lower your LDL cholesterol levels by making healthy changes to your lifestyle, such as choosing foods lower in saturated and trans fats and maintaining a healthy weight. […] You and your health care team can work together to prevent or treat other health conditions and ensure that they don’t lead to high LDL cholesterol. […] You may need to have your cholesterol levels tested at least once every 4 to 6 years if you do not have heart disease.

• #1 High cholesterol – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800

  High cholesterol can be inherited. That means it can pass from parents to children through genes. But high cholesterol often is the result of lifestyle choices such as not getting enough exercise, not eating a balanced diet or consuming large amounts of saturated fat. You can make changes to help prevent it. And if you have high cholesterol, you can help lower it with a healthy diet, regular exercise and sometimes medicine. […] The same heart-healthy lifestyle changes that can lower cholesterol also can help prevent high cholesterol. You can practice the following habits: Eat a diet that focuses on lean protein, fruits, vegetables and whole grains. Limit sodium and added sugar. Also limit the amount of saturated and trans fats you eat. Instead, eat foods with healthy fats such as fatty or oily fish, nuts, and olive or canola oil. Lose extra weight and keep it off. If you smoke, ask your care team to help you quit. Exercise on most days of the week for at least 30 minutes. Drink less alcohol, if at all. Limit alcohol to no more than up to one drink a day for women and up to two drinks a day for men.

• #1 Preventing High Cholesterol | Cholesterol | CDC

  https://www.cdc.gov/cholesterol/prevention/index.html

  By living a healthy lifestyle, you can help keep your cholesterol in a healthy range. […] Overweight and obesity raise levels of low-density lipoprotein (LDL or bad) cholesterol. […] Eating lots of foods high in saturated fat and trans fat may contribute to high cholesterol and related conditions, such as heart disease. […] Limit foods high in saturated fat. […] Choose foods that are low in saturated fat, trans fat, sodium (salt), and added sugars. […] Eat foods naturally high in fiber, such as oatmeal and beans (black, pinto, kidney, lima, and others), and unsaturated fats (found in avocados, vegetable oils like olive oil, and nuts). These foods may help prevent and manage high levels of LDL („bad”) cholesterol and triglycerides while increasing high-density lipoprotein (HDL, or „good”) cholesterol levels.

• #1 10 Natural Ways to Lower Your Cholesterol Levels

  https://www.healthline.com/nutrition/how-to-lower-cholesterol

  Excess weight or obesity can increase your risk of developing high cholesterol levels. Losing weight, if one has excess weight, can help lower ones cholesterol levels. […] Smoking tobacco increases the risk of heart disease in several ways, including increasing LDL and decreasing HDL. […] According to a 2018 research review, clinical studies show that taking 1.53 grams of plant sterols or stanols daily can reduce LDL concentration by 7.512%. […] Unsaturated fats, soluble fiber, and plant sterols or stanols can increase good HDL and decrease bad LDL. Exercise and weight loss can also help.

• #1 Preventing High Cholesterol | Cholesterol | CDC

  https://www.cdc.gov/cholesterol/prevention/index.html

  Overweight and obesity raise levels of LDL („bad”) cholesterol. Excess body fat affects how your body uses cholesterol and slows down your body’s ability to remove LDL cholesterol from your blood. The combination raises your risk of heart disease and stroke. […] Physical activity can help you maintain a healthy weight and lower your cholesterol and blood pressure levels. […] Smoking damages your blood vessels, speeds up the hardening of the arteries, and greatly increases your risk for heart disease. […] Too much alcohol can raise cholesterol levels and levels of triglycerides, a type of fat in the blood. […] You and your health care team can work together to prevent high cholesterol.

• #1 10 Natural Ways to Lower Your Cholesterol Levels

  https://www.healthline.com/nutrition/how-to-lower-cholesterol

  Limiting saturated fats in your diet, along with getting regular exercise, and engaging in other healthy practices, may help lower the amount of low-density lipoprotein (LDL) in your blood. […] In contrast, theres strong evidence that a diet high in monounsaturated fats, such as the Mediterranean diet, helps reduce harmful LDL and increase healthy HDL. […] Research from 2018 shows that polyunsaturated fats reduce LDL cholesterol and decrease the risk of heart disease. […] Trans fats increase LDL and total cholesterol while decreasing beneficial HDL. […] Prioritizing whole grains can help lower LDL cholesterol levels and may have a protective effect against cardiovascular diseases. […] Exercise is a win-win for heart health. It improves physical fitness and helps prevent obesity, but it also reduces harmful LDL and increases beneficial HDL.

• #1 Prevention and Treatment of High Cholesterol (Hyperlipidemia) | American Heart Association

  https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia

  Physical activity is important. At least 150 minutes of moderate-intensity aerobic exercise a week is enough to lower both cholesterol and high blood pressure. […] By quitting, smokers can lower their triglycerides and increase their HDL cholesterol levels. […] But a weight loss of as little as 5% to 10% may help improve some cholesterol numbers and other heart disease risk factors. […] Your health care professional can help you reach your health goals, including keeping your cholesterol at healthy levels.

• #1

  https://www.nhs.uk/conditions/high-cholesterol/how-to-lower-your-cholesterol/

  To reduce your cholesterol, try to cut down on fatty food, especially food that contains a type of fat called saturated fat. […] Aim to do at least 150 minutes (2.5 hours) of exercise a week. […] Smoking can raise your cholesterol and make you more likely to have serious problems like heart attacks, strokes and cancer. […] Try to avoid drinking more than 14 units of alcohol a week.

• #1 7 Ways To Prevent High Cholesterol – Elite Hospital Kingwood

  https://elitekingwood.com/7-ways-to-prevent-high-cholesterol/

  Physical exercise has a significant impact on triglycerides by lowering them and HDL, the good cholesterol, by increasing it. […] At least 150 minutes of moderate-intensity aerobic exercise a week is enough to lower cholesterol and high blood pressure. […] Quitting smoking improves your HDL cholesterol level. […] Moderate drinking, which the NIH defines as one drink per day for women and two drinks per day for men, is the amount of alcohol considered to have a protective effect on the heart. […] Some experts suggest that stress and cholesterol are interlinked. Preventing stress may help to prevent high cholesterol caused by it. […] In some cases, dietary and lifestyle changes aren’t enough to lower cholesterol levels. If your doctor recommends medication to lower your cholesterol, take it as prescribed while continuing your lifestyle changes.

• #1 Patient education: High cholesterol and lipid treatment options (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/high-cholesterol-and-lipid-treatment-options-beyond-the-basics/print

  If you have high low-density lipoprotein (LDL) cholesterol, you should try to make some changes in your day-to-day habits, including reducing the amount of total and saturated fat in your diet, losing weight (if you are overweight or obese), getting regular aerobic exercise, and eating plenty of fruits and vegetables. […] There are many medications available to help lower elevated levels of LDL cholesterol. […] Statins are one of the best-studied classes of medications and the most commonly used drugs for lowering LDL cholesterol. […] Ezetimibe (brand name: Zetia) blocks the body’s ability to actively transport cholesterol from food as well as cholesterol that the body produces internally. […] Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibody inhibitors are another class of drugs that lower LDL cholesterol levels. […] The treatment of high cholesterol and/or triglycerides is a lifelong process. […] Stopping treatment usually allows lipid levels to rise again and increases your risk for heart attack, stroke, or other cardiovascular problems.

• #1 Low-density lipoprotein cholesterol-lowering therapy in the primary prevention of cardiovascular disease – UpToDate

  https://www.uptodate.com/contents/low-density-lipoprotein-cholesterol-lowering-therapy-in-the-primary-prevention-of-cardiovascular-disease

  Lowering low-density lipoprotein cholesterol (LDL-C) can reduce the risk of atherosclerotic cardiovascular disease (CVD) in people without established CVD. This approach to CVD prevention is called primary prevention. The rationale for LDL-C reduction is based upon clinical trial evidence that lowering of LDL-C in patients across a broad range of LDL-C levels reduces a patient’s risk of CVD. […] The decision about whether to lower LDL-C with pharmacotherapy incorporates both LDL-C level and a patient’s estimated 10-year CVD risk. These factors help guide shared decision-making (ie, risk and benefit) discussions between patients and their providers. […] We conduct CVD risk evaluation and discussion with our patients when they reach 20 years of age or at their first encounter with the health care system if they are older than 20 years of age. A 10-year CVD risk assessment (for patients ages 30 to 79 years) can help guide LDL-C-lowering strategies (including statin therapy), and a 10-year or lifetime CVD risk assessment can guide preventive care.

• #1 Recommendation: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/statin-use-in-adults-preventive-medication

  For adults aged 40 to 75 years who have 1 or more cardiovascular risk factors (ie, dyslipidemia, diabetes, hypertension, or smoking) and an estimated 10-year cardiovascular disease (CVD) risk of 10% or greater: Initiate a statin. […] For adults aged 40 to 75 years who have 1 or more cardiovascular risk factors (ie, dyslipidemia, diabetes, hypertension, or smoking) and an estimated 10-year CVD risk of 7.5% to less than 10%: Selectively offer a statin. […] These recommendations apply to adults 40 years or older who do not already have CVD or signs or symptoms of CVD. […] The USPSTF concludes with moderate certainty that statin use for the prevention of CVD events and all-cause mortality in adults aged 40 to 75 years with no history of CVD and who have 1 or more CVD risk factors (ie, dyslipidemia, diabetes, hypertension, or smoking) and an estimated 10-year CVD event risk of 10% or greater has at least a moderate net benefit.

• #1 Low-density lipoprotein cholesterol-lowering therapy in the primary prevention of cardiovascular disease – UpToDate

  https://www.uptodate.com/contents/low-density-lipoprotein-cholesterol-lowering-therapy-in-the-primary-prevention-of-cardiovascular-disease

  We also determine a patient’s CVD risk using risk assessment tools that estimate the patient’s 10-year risk of CVD based upon their baseline LDL-C and other risk factors (eg, blood pressure, smoking). Recommendations for selecting and using an atherosclerotic CVD (ASCVD) risk calculator and features of specific risk calculators are discussed in detail separately. […] We define the following risk categories based on a person’s estimated 10-year risk of CVD: […] High (7.5 to 20 percent) and very high (greater than or equal to 20 percent) 10-year CVD risk — For most patients with an LDL-C >100 mg/dL (>2.59 mmol/L) and a predicted 10-year CVD risk of greater than 7.5 percent, we initiate statin therapy. […] We usually choose a moderate-dose statin as initial therapy. Examples of a moderate dose of a statin are 10 to 20 mg of atorvastatin or 5 to 10 mg of rosuvastatin.

• #1 Hyperlipidemia: Drugs for Cardiovascular Risk Reduction in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0115/p78.html

  Niacin should not be used. […] The role of proprotein convertase subtilisin/kexin type 9 inhibitors is unclear, but initial studies suggest a decrease in the rate of acute ASCVD events in patients with hypercholesterolemia. […] Patients with a high risk of ASCVD (a 10-year risk of at least 7.5% or 10%, depending on the guideline) should receive statin therapy for primary prevention. […] Statin therapy should be prescribed for secondary prevention in patients with known ASCVD, unless contraindicated. […] Niacin, fibrates, and omega-3 fatty acids should not be routinely prescribed for primary or secondary prevention of ASCVD. […] A moderate-intensity statin plus ezetimibe should be considered as an alternative in patients with acute coronary syndrome who do not tolerate high-intensity statin therapy.

• #1 Patient education: High cholesterol and lipid treatment options (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/high-cholesterol-and-lipid-treatment-options-beyond-the-basics/print

  The decision to start cholesterol-lowering treatment is made on a case-by-case basis. Clinicians consider current lipid levels, your risk of developing a cardiac event, the presence or absence of cardiovascular disease (CVD), and other risk factors. […] Studies have shown that in people with coronary heart disease, taking medication to significantly lower the level of „bad” cholesterol, called low-density lipoprotein (LDL) cholesterol, is beneficial. […] People without a history of cardiovascular disease (CVD) also benefit from cholesterol-lowering therapy, although the goal is generally not as aggressive as in people with CVD. […] The first step is to reduce the LDL to below the target level (see 'Statins’ below) and then check the fasting triglyceride level. […] A moderate- or high-intensity statin is recommended in most adults with diabetes, regardless of their baseline LDL cholesterol level.

• #1 Guidelines for the Management of High Blood Cholesterol – Endotext – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK305897/

  The LDL-C hypothesis holds that high blood LDL-C levels are a major risk factor for atherosclerosis cardiovascular disease (ASCVD) and lowering LDL-C levels will reduce the risk for ASCVD. […] LDL-C levels can be reduced by both lifestyle interventions and cholesterol-lowering drugs. […] Following these general principles will help clinicians make informed decisions in deciding on their approach to lowering LDL-C levels and will facilitate discussions with patients on the benefits and risks of treatment. […] In patients with severe primary hypercholesterolemia (LDL-C greater than 190mg/dL (4.9mMol/L)) without concomitant ASCVD begin high-intensity statin therapy (or moderate intensity statin + ezetimibe) to achieve an LDL-C goal of 100mg/dL; if this goal is not achieved consider adding a PCSK9 inhibitor in selected patients at higher risk.

• #1 Low-density lipoprotein cholesterol-lowering therapy in the primary prevention of cardiovascular disease – UpToDate

  https://www.uptodate.com/contents/low-density-lipoprotein-cholesterol-lowering-therapy-in-the-primary-prevention-of-cardiovascular-disease

  For patients with LDL-C <190 mg/dL (4.9 mmol/dL) and a 10-year risk between 5 and 7.5 percent, we undertake shared decision-making with the patient, including a detailed discussion of the potential benefits and costs/risks. [...] For patients with LDL-C <190 mg/dL (4.9 mmol/dL) and a 10-year risk less than 5 percent, we do not start statin therapy. [...] Our approach to LDL-C lowering is summarized in an algorithm. [...] The LDL-C should be measured four to six weeks after initiating statin therapy in order to assess LDL-C lowering and statin adherence. If LDL-C reduction has not been achieved, we assess adherence and consider adjusting therapy. [...] In patients in these high- and very high-risk categories, we will subsequently adjust treatment if the patient has not achieved adequate LDL-C lowering. [...] In the setting of primary prevention, indications for nonstatin treatment include the following: For patients who are statin intolerant, or those who are unwilling to start a statin due to fear of side effects, use of nonstatin agents can be an alternative.

• #1 High cholesterol – symptoms, causes and levels – BHF

  https://www.bhf.org.uk/informationsupport/risk-factors/high-cholesterol

  There is lots you can do to help lower your cholesterol: try ways of getting more active, which will help lower your cholesterol but also help you sleep better and feel more energetic; cut down on alcohol and stop smoking; enjoy trying healthy foods and recipes that are good for your heart. […] If lifestyle changes are not enough to lower your high cholesterol, your doctor may suggest medication. If you are diagnosed with high cholesterol, your GP should invite you for a blood test every year to check your levels and adjust your treatment if necessary.

• #1 Cholesterol-Lowering Strategies for Cardiovascular Disease Prevention: The Importance of Intensive Treatment and the Simplification of Medical Therapy

  https://www.mdpi.com/2077-0383/13/7/1882

  Cholesterol-Lowering Strategies for Cardiovascular Disease Prevention: The Importance of Intensive Treatment and the Simplification of Medical Therapy […] Cardiovascular diseases (CVDs) are a leading global cause of mortality and are primarily driven by atherosclerotic coronary artery disease. Their pathogenesis involves multi-factorial mechanisms, among which low-density lipoprotein (LDL) plays a causative role. Recent ESC/EAS guidelines advocate for a shift toward new risk estimation algorithms that better emphasize non-fatal cardiovascular events, lifetime risk prediction, and tailored pharmacological approaches, including statin + ezetimibe and triple therapy, in specific cases. Intensive lipid-lowering therapy has been shown to be pivotal, especially in post-acute coronary events. […] The pathogenesis of atherosclerotic coronary artery disease is multi-factorial, but data from clinical and epidemiological studies have confirmed the causative role of low-density lipoproteins (LDLs) in the genesis and progression of the disease. This has spurred research on pharmacological treatments aimed at controlling and reducing the atherosclerotic burden in patients at risk of developing coronary artery disease. A reduction in LDL levels is associated with a proportional decrease in the risk of cardiovascular events, both in terms of the extent of reduction and the duration of treatment. This “lower is better” concept has prompted recent guidelines to substantially lower the LDL threshold.

• #1 ACC-AHA cardiovascular prevention guidelines drop cholesterol treatment goals | MDedge

  https://blogs.the-hospitalist.org/content/acc-aha-cardiovascular-prevention-guidelines-drop-cholesterol-treatment-goals

  A move away from specific cholesterol treatment targets, assessment of both 10-year and lifetime cardiovascular disease risk, and inclusion of stroke in cardiovascular disease risk estimates are among the highlights of updated clinical practice guidelines on reducing cardiovascular risk released Nov. 12 by the American College of Cardiology and American Heart Association. […] The cholesterol treatment guideline provides „a new perspective on LDL and non-HDL treatment goals,” with the identification of the four groups of patients for whom moderate- or high-intensity statin treatment is recommended, for primary or secondary prevention, explained Dr. Neil J. Stone, chair of the writing committee. […] In the cholesterol treatment guideline, Dr. Stone said that based on an extensive literature review, the evidence supported the use of the „appropriate intensity” of statin therapy in addition to a heart-healthy lifestyle to reduce risk, with the identification of four „major statin benefit groups” for whom „high intensity” statin treatment (lowering LDL by at least 50%) or „moderate intensity” statin treatment (lowering LDL by roughly 30%-49%) is recommended.

• #1 ACC-AHA cardiovascular prevention guidelines drop cholesterol treatment goals | MDedge

  https://blogs.the-hospitalist.org/content/acc-aha-cardiovascular-prevention-guidelines-drop-cholesterol-treatment-goals

  „These guidelines are based on an objective review of the evidence and that evidence is clear: There is no evidence for treating to specific target numbers for cholesterol. Yet, there is clear and strong evidence for the use of statin medications for people at elevated risk for heart disease and stroke,” he said. […] „The new treatment approach is more patient centered; it is about treating those who are most likely to benefit from taking a chronic medication; it is about reducing their risk with proven medicines; and it also reduces patient burden by lessening the need for repeat testing and taking additional, unproven medications,” he said in an interview.

• #1 The Future of Heart Health: UNM Researcher Develops Vaccine to Lower Cholesterol | UNM HSC Newsroom

  https://hscnews.unm.edu/news/the-future-of-heart-health-unm-researcher-develops-vaccine-to-lower-cholesterol

  UNM researchers developed a vaccine to block a protein that heightens cholesterol levels, by creating an antibody response against the particles. […] A new vaccine developed by researchers at The University of New Mexico School of Medicine could be a game-changer, providing an inexpensive method to lower bad LDL cholesterol, which creates dangerous plaques that can block blood vessels. […] In a recent study published in NPJ Vaccines, a team led by Bryce Chackerian, PhD, Regents Professor in the Department of Molecular Genetics Microbiology, reported the vaccines lowered LDL cholesterol almost as effectively as an expensive class of drugs known as PCSK9 inhibitors. […] Chackerian and his colleagues wanted all patients who face that risk to have a treatment option. […] This is a vaccine that we think can have a global impact. So, not just in the United States, but around the world where heart disease is a significant problem.

• #1 Managing cholesterol | Heart and Stroke Foundation

  https://www.heartandstroke.ca/heart-disease/risk-and-prevention/condition-risk-factors/managing-cholesterol

  High blood cholesterol is one of the major controllable risk factors for coronary heart disease, heart attack and stroke. […] As your blood cholesterol rises, so does your risk of coronary heart disease. […] Making some lifestyle changes is a positive way to control your blood cholesterol levels. […] Heart Stroke recommends that you: […] 1. Eat a healthy balanced diet. […] 2. Cook and eat more meals at home […] 3. Make eating out a special occasion […] 4. Achieve and maintain a healthy weight […] 5. Maintain physical activity […] 6. Be smoke-free. […] Sometimes diet and exercise are not enough to lower your blood cholesterol levels. Several drugs are available to lower your blood cholesterol. Your doctor may prescribe medications to including statins and other cholesterol lowering medication. […] These medications do not cure high blood cholesterol or replace a healthy lifestyle.

• #1 Prevent and Manage High Cholesterol | Homeland Security

  https://www.dhs.gov/employee-resources/news/2023/09/27/prevent-and-manage-high-cholesterol

  Engage in regular physical activity. Regular physical activity can help lower LDL (bad) and raise HDL (good) cholesterol levels. Adults need 150 minutes of moderate-intensity exercise and two days of muscle strengthening activity each week. Children and adolescents should get one hour of physical activity every day. […] Work with your health care professional. Consult with your doctor to establish an effective cholesterol management plan. Your health care professional will work on a food and fitness plan to help you reach or maintain a healthy weight.

• #2 Patient education: High cholesterol and lipid treatment options (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/high-cholesterol-and-lipid-treatment-options-beyond-the-basics/print

  A high cholesterol level (also called „hypercholesterolemia”) can significantly increase your risk of developing chest pain, heart attack, and stroke. Fortunately, a number of effective treatment options are available. […] Cholesterol levels (notably LDL cholesterol and triglycerides) can almost always be lowered with a combination of weight loss (achieved with diet and exercise), and medications. As your level decreases, so does your risk of developing cardiovascular disease (CVD), including disease of the blood vessels supplying the heart (coronary artery disease), brain (cerebrovascular disease), and limbs (peripheral vascular disease). This results in a decrease in your risk of having a heart attack or stroke. Even if you already have established CVD, it is not too late to lower your risk.

• #2 High Cholesterol Prevention and Management – Orange County

  https://www.hoag.org/specialties-services/heart-vascular/specialty-programs/general-cardiovascular-health/conditions/high-cholesterol/

  If you have any major risk factors for high cholesterol, consider having your cholesterol checked every year or two, even if you’re younger. […] High cholesterol is usually treated in two ways: reducing harmful lifestyle factors like obesity, a diet high in saturated fat and trans fat, lack of cardiovascular exercise and more, and taking certain cholesterol-lowering medications. […] There are certain healthy lifestyle changes you can make to reduce your risk of developing the condition or lower your LDL cholesterol levels if they are high. […] These lifestyle changes may include: Get plenty of cardiovascular exercise and physical activity, which can increase blood flow, reduce levels of bad cholesterol (LDL) and increase levels of good cholesterol (HDL). […] Eat a heart-healthy diet that low in saturated fat and trans fats, includes healthy vegetable oil like canola or olive oil, and plenty of fruits, nuts, leafy greens and whole grains. […] If you are concerned about your cholesterol levels, talk with your primary care provider about getting your cholesterol checked and your risk factors.

• #2 Hyperlipidemia (High Cholesterol): Levels, Causes, Symptoms & Diagnosis

  https://my.clevelandclinic.org/health/diseases/21656-hyperlipidemia

  Even children can get their blood checked for high cholesterol, especially if someone in the child’s family had a heart attack, stroke or high cholesterol. Children and young adults can get checked every five years. […] Once you reach middle age, you should have your cholesterol checked every year or two. Your healthcare provider can help you decide how often you should have a hyperlipidemia screening. […] Changes you make in your life can keep you from getting hyperlipidemia. Things you can do include: Stop smoking. Stay active instead of sitting too much. Keep your stress level down. Get the right amount of sleep. Eat healthy foods. Cut back on eating fatty meats. Don’t buy snacks that have trans fat on the label. Stay at a healthy weight. […] Although high cholesterol puts you at risk for heart attacks and stroke, you can protect yourself by living a healthier lifestyle and taking medicine if needed.

• #2 The Power of Prevention: A Comprehensive Guide to Healthy Cholesterol Levels | AdventHealth

  https://www.adventhealth.com/blog/power-prevention-a-comprehensive-guide-healthy-cholesterol-levels

  Knowing your cholesterol numbers is an important step in keeping yourself healthy. High cholesterol is a major risk factor for several serious health conditions, including stroke and heart disease, the leading cause of death for both men and women in the United States. […] You may not be able to control certain risk factors for high cholesterol, like your family history. Still, there are plenty of ways you can improve your numbers, such as being intentional about the following: […] Dietary guidelines for cholesterol emphasize focusing on a healthy diet instead of a specific cholesterol target. That means eating a diet high in fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean animal protein or plant protein sources, and a diet low in salt, added sugars, and trans and saturated fats.

• #2 Top 5 lifestyle changes to improve your cholesterol

  https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/reduce-cholesterol/art-20045935

  Lifestyle changes can help improve your cholesterol and boost the cholesterol-lowering power of medications. […] High cholesterol increases your risk of heart disease and heart attacks. […] If you already take medications, these changes can improve their cholesterol-lowering effect. […] Exercise can improve cholesterol. Moderate physical activity can help raise high-density lipoprotein (HDL) cholesterol, the „good” cholesterol. […] Quitting smoking improves your HDL cholesterol level. […] Sometimes healthy lifestyle changes aren’t enough to lower cholesterol levels. If your doctor recommends medication to help lower your cholesterol, take it as prescribed while continuing your lifestyle changes. Lifestyle changes can help you keep your medication dose low.

• #2 High cholesterol? Here’s what to do about it | UCLA Health

  https://www.uclahealth.org/news/article/high-cholesterol-heres-what-you-can-do-about-it

  Reducing cholesterol is an area where lifestyle choices can make a significant difference. […] Foods to minimize or avoid are those with saturated fat or trans fats, as reducing consumption of these foods can help lower cholesterol. […] Polyunsaturated and monounsaturated fats are better choices, Dr. Ko says. […] Fiber is another dietary element that impacts cholesterol, particularly soluble fiber. […] Exercise is also helpful to reduce triglycerides and raise HDL levels, Dr. Ko says. Exercise and dietary changes that contribute to weight loss also lower LDL levels. […] Patients who lose weight, make changes to their diet, minimize saturated fat, go up on plant-based fats really can make a positive impact on their cholesterol panel.

• #2 Prevention and Treatment of High Cholesterol (Hyperlipidemia) | American Heart Association

  https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia

  When it comes to cholesterol, it’s important to know your numbers. […] If you’re diagnosed with high cholesterol, your overall health and other risks such as smoking or high blood pressure will help guide treatment. […] The good news is that high cholesterol can be lowered, reducing the risk of heart disease and stroke. […] Often, changing behaviors can help bring your numbers into line. […] If lifestyle changes alone don’t improve your cholesterol levels, medication may be prescribed. […] From a dietary standpoint, the best way to lower your cholesterol is to reduce your intake of saturated fat and trans fat. […] A heart-healthy diet emphasizes fruits, vegetables, whole grains, poultry, fish, nuts and nontropical vegetable oils, while limiting red and processed meats, sodium and sugar-sweetened foods and beverages.

• #2

  https://www.healthxchange.sg/high-cholesterol/prevention/how-to-lower-bad-cholesterol-ldl

  High levels of total and low-density lipoprotein (LDL) or bad cholesterol, increase the risk of cardiovascular disease. Research has shown that lowering LDL by 1 mmol/L is estimated to reduce risk of heart attack and stroke by about 26%1. […] Those with higher risk for cardiovascular events of stroke and heart attack would be advised to start medications in order to control risk adequately. […] Other individuals who are not at high risk, have the option to control their LDL cholesterol through non pharmacological means, if they so prefer. […] Because even if risk is not high now, it accumulates with time, the longer that individual has cholesterol levels above his or her optimal level, the higher the risk. This is where diet can help. […] Diet can reduce significantly the levels of bad cholesterol, reduction by ~30%2 or more has been described in the literature.

• #2 Prevention and Treatment of High Cholesterol (Hyperlipidemia) | American Heart Association

  https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia

  Physical activity is important. At least 150 minutes of moderate-intensity aerobic exercise a week is enough to lower both cholesterol and high blood pressure. […] By quitting, smokers can lower their triglycerides and increase their HDL cholesterol levels. […] But a weight loss of as little as 5% to 10% may help improve some cholesterol numbers and other heart disease risk factors. […] Your health care professional can help you reach your health goals, including keeping your cholesterol at healthy levels.

• #2 Cholesterol Management: Lifestyle, Diet, and Medication Guide

  https://www.healthline.com/health/high-cholesterol/cholesterol-management

  Studies have shown that vegetarian diets, like the Portfolio Diet, can effectively lower cholesterol. The current Dietary Guidelines for Americans suggest that you can replace proteins from high fat meats with protein from plants. The AHA suggests that a plant-based diet could help reduce your cholesterol without using medications. […] According to the AHA, losing about 5% to 10% of your weight can help reduce your cholesterol levels. […] Statins are the most prescribed cholesterol medications. They work by decreasing cholesterol production in your liver. Statins are generally very effective at reducing LDL cholesterol and lowering your risk of heart attack and stroke. […] Some types of supplements may help lower cholesterol levels. It’s important to talk with a doctor before taking supplements since they may come with risks.

• #2 Prevent and Manage High Cholesterol | Homeland Security

  https://www.dhs.gov/employee-resources/news/2023/09/27/prevent-and-manage-high-cholesterol

  According to the Centers for Disease Control and Prevention (CDC), nearly 2 in 5 adults in the United States have high cholesterol. High cholesterol can cause health problems such as heart disease and stroke, two leading causes of death in the United States. […] Although you cannot control some of these risk factors, you can take steps to lower your risk of high cholesterol. […] Do not smoke and limit alcohol intake. Smoking damages blood vessels and greatly increases your risk for heart disease. Too much alcohol can raise cholesterol levels and levels of triglycerides, a type of fat in the blood. […] Eat a healthy diet. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol levels. […] Maintain a healthy weight. Being overweight is a risk factor for heart disease and tends to increase your cholesterol. Losing weight can help lower your low-density lipoprotein (LDL) and total cholesterol levels, as well as raise your high-density lipoprotein (HDL) and lower your triglyceride levels.

• #2 7 Ways To Prevent High Cholesterol – Elite Hospital Kingwood

  https://elitekingwood.com/7-ways-to-prevent-high-cholesterol/

  Here are seven tips to keep your cholesterol level in a healthy range and lower your risk of heart disease and stroke. […] One of the best ways to lower your cholesterol is to reduce your saturated fat intake and trans-fat. […] Reducing these fats means limiting your intake of red meat, sodium and sugar-sweetened foods, beverages, and dairy products made with whole milk. […] Certain foods can help either lower LDL cholesterol directly or block your body from absorbing cholesterol. […] Being overweight tends to raise bad cholesterol and lower good cholesterol. […] A weight loss of as little as 5% to 10% can help improve cholesterol numbers. […] With a combination of weight loss and a healthy diet, it’s possible to lower LDL levels up to 30%, results that are similar to taking cholesterol-lowering drugs.

• #2 The Power of Prevention: A Comprehensive Guide to Healthy Cholesterol Levels | AdventHealth

  https://www.adventhealth.com/blog/power-prevention-a-comprehensive-guide-healthy-cholesterol-levels

  Physical activity can help you maintain a healthy weight and lower cholesterol levels. Just by making small changes, like taking the stairs instead of the elevator, you can help maximize your health. […] If you dont currently smoke, you can help your health simply by not starting. If you do smoke, however, cutting the habit can help lower your risk for heart disease. […] Because excess body fat affects how the body uses cholesterol and slows down its ability to remove LDL cholesterol from the blood, its important to maintain a healthy weight. […] If changing your lifestyle habits doesnt do enough to lower your cholesterol levels, you may need medication. Statins, which block a substance the body needs to make cholesterol, are common medications used to lower cholesterol levels. […] High cholesterol can become a serious issue if left unmanaged. If youre worried about your cholesterol, reach out to your doctor. Together, we can determine your health care needs and help you regulate your cholesterol levels.

• #2

  https://www2.hse.ie/conditions/high-cholesterol/prevention/

  You can lower your cholesterol by: […] eating a healthy, balanced diet that’s low in saturated fat […] exercising regularly […] not smoking […] cutting down on alcohol. […] Avoid foods containing saturated fats. They will increase the levels of „bad cholesterol” in your blood. […] It’s important to replace saturated fats with unsaturated fats. They increase levels of „good cholesterol” and reduce any blockage in your arteries. […] A low-fat diet including lots of fibre and plenty of fruit and vegetables has also been shown to help lower cholesterol. […] High-density lipoprotein (HDL) cholesterol is known as the „good” cholesterol because it helps remove other forms of cholesterol from your bloodstream. […] A chemical found in cigarettes stops HDL transporting fatty deposits to the liver. This leads to high cholesterol and narrowing of the arteries (atherosclerosis).

• #2

  https://www.nbcnews.com/health/health-news/millions-unaware-heart-attacks-strokes-cholesterol-prevention-rcna135654

  The hope is that we can keep them safe until we can get one of these drugs on the market, Nissen, who is an investigator for clinical trials of lepodisiran, said. […] He and other cardiologists are calling for widespread screening of Lp(a). […] „Why wait for those new drugs?” said Michos of Johns Hopkins. Measuring Lp(a) now „identifies a high-risk patient. We can be proactive about prevention. We can take action.” […] That is, maintaining a normal weight, getting regular exercise, stopping smoking and eating a diet rich in fruits, vegetables and whole grains are effective ways of managing heart risks overall, even for people with elevated Lp(a), Michos said. […] Welsh’s mother had the first of three heart attacks in her late 40s. Doctors tested her Lp(a) levels and explained how they greatly elevated her heart risks.

• #2 How to Lower Cholesterol with Diet: MedlinePlus

  https://medlineplus.gov/howtolowercholesterolwithdiet.html

  Instead of saturated fats, switch to foods with healthier fats, such as lean meat, nuts, and unsaturated oils like canola, olive, and safflower oils. […] If you are trying to lower your cholesterol, you should have less than 200 mg a day of cholesterol. […] Soluble fiber helps prevent your digestive tract from absorbing cholesterol. You should try to get 10 to 25 grams of it per day. […] Increase plant stanols and sterols in your diet. These are substances that also help prevent your digestive tract from absorbing cholesterol. […] These special fats can lower LDL and triglyceride levels. […] You should try to limit the amount of sodium (salt) that you eat to no more than 2,300 milligrams (about 1 teaspoon of salt) a day. […] Limiting salt won’t lower your cholesterol, but it can lower your risk of heart diseases by helping to lower your blood pressure. […] Alcohol adds extra calories, which can lead to weight gain. Being overweight can raise your LDL level and lower your HDL level. Too much alcohol can also increase your risk of heart diseases because it can raise your blood pressure and triglyceride level.

• #2

  https://www2.hse.ie/conditions/high-cholesterol/prevention/

  Being active and exercising regularly will increase the levels of HDL in your body. […] Exercise will also help you maintain a healthy weight, and lose weight if you’re overweight. […] Doing 150 minutes of moderate-intensity exercise every week is recommended to help lower your cholesterol. […] Try to: avoid drinking more than the recommended weekly units – 11 standard drinks for women and 17 standard drinks for men […] have several drink-free days each week […] avoid drinking lots of alcohol in a short time (binge drinking).

• #2 Prevention and Treatment of High Cholesterol (Hyperlipidemia)? | Medanta

  https://www.medanta.org/patient-education-blog/prevention-and-treatment-of-high-cholesterol-hyperlipidemia

  Smoking compromises your blood vessels, accelerates artery hardening, and significantly raises your risk for heart disease. […] Alcoholism can increase blood triglyceride and cholesterol levels, both of which are types of fat. Aim to limit your alcohol consumption. […] The main objective of treatment is to lower, or regulate, your LDL level to reduce your individual danger of a heart attack or cardiovascular disease. […] The first line of defense against high cholesterol is changing ones lifestyle via activities like exercise and good eating. However, your doctor could suggest medication if you’ve made these significant lifestyle changes but your cholesterol levels are still high. […] Statin drugs: These can help lower blood cholesterol levels by reducing the amount of cholesterol the liver produces.

• #2 Patient education: High cholesterol and lipid treatment options (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/high-cholesterol-and-lipid-treatment-options-beyond-the-basics/print

  The decision to start cholesterol-lowering treatment is made on a case-by-case basis. Clinicians consider current lipid levels, your risk of developing a cardiac event, the presence or absence of cardiovascular disease (CVD), and other risk factors. […] Studies have shown that in people with coronary heart disease, taking medication to significantly lower the level of „bad” cholesterol, called low-density lipoprotein (LDL) cholesterol, is beneficial. […] People without a history of cardiovascular disease (CVD) also benefit from cholesterol-lowering therapy, although the goal is generally not as aggressive as in people with CVD. […] The first step is to reduce the LDL to below the target level (see 'Statins’ below) and then check the fasting triglyceride level. […] A moderate- or high-intensity statin is recommended in most adults with diabetes, regardless of their baseline LDL cholesterol level.

• #2 Low-density lipoprotein cholesterol-lowering therapy in the primary prevention of cardiovascular disease – UpToDate

  https://www.uptodate.com/contents/low-density-lipoprotein-cholesterol-lowering-therapy-in-the-primary-prevention-of-cardiovascular-disease

  We also determine a patient’s CVD risk using risk assessment tools that estimate the patient’s 10-year risk of CVD based upon their baseline LDL-C and other risk factors (eg, blood pressure, smoking). Recommendations for selecting and using an atherosclerotic CVD (ASCVD) risk calculator and features of specific risk calculators are discussed in detail separately. […] We define the following risk categories based on a person’s estimated 10-year risk of CVD: […] High (7.5 to 20 percent) and very high (greater than or equal to 20 percent) 10-year CVD risk — For most patients with an LDL-C >100 mg/dL (>2.59 mmol/L) and a predicted 10-year CVD risk of greater than 7.5 percent, we initiate statin therapy. […] We usually choose a moderate-dose statin as initial therapy. Examples of a moderate dose of a statin are 10 to 20 mg of atorvastatin or 5 to 10 mg of rosuvastatin.

• #2 Hyperlipidemia: Drugs for Cardiovascular Risk Reduction in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0115/p78.html

  Guidelines from the American College of Cardiology/American Heart Association (ACC/AHA) and the U.K. National Institute for Health and Care Excellence (NICE) indicate that lipid-lowering drugs have benefit for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) events. […] The ACC/AHA guideline recommends starting moderate- to high-intensity statins if the risk is 7.5% or greater, whereas the NICE and USPSTF guidelines recommend statins if the risk is 10% or greater. […] Patients with known ASCVD should receive high-intensity statins unless they fall into special categories (e.g., older age) or do not tolerate high-intensity statins, in which case moderate-intensity statins are appropriate. […] Other lipid-lowering drugs (e.g., bile acid sequestrants, ezetimibe) can be considered if patients do not tolerate statins.

• #2 Hyperlipidemia: Drugs for Cardiovascular Risk Reduction in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0115/p78.html

  Recommendations and guidelines from the ACC/AHA, U.K. National Institute for Health and Care Excellence (NICE), and U.S. Preventive Services Task Force (USPSTF) have eliminated goals for low-density lipoprotein cholesterol (LDL-C) and nonhigh-density lipoprotein cholesterol levels because studies to date have focused on treatment intensity rather than cholesterol levels. […] The ACC/AHA also recommends that patients with a 10-year risk between 5.0% and 7.5% be considered for statin therapy. […] Based on study findings, statin therapy may be recommended for primary prevention of cardiovascular events in patients with or without diabetes and a 10-year ASCVD risk of at least 7.5% according to the ACC/AHA guideline, or at least 10% according to the NICE and USPSTF guidelines. […] There is no convincing evidence that routine use of non-statin lipid-lowering medications (i.e., ezetimibe [Zetia], niacin, fibrates, and omega-3 fatty acids) are useful in the primary prevention of ASCVD.

• #2 Cholesterol-Lowering Strategies for Cardiovascular Disease Prevention: The Importance of Intensive Treatment and the Simplification of Medical Therapy

  https://www.mdpi.com/2077-0383/13/7/1882

  The timing of treatment initiation also plays a crucial role. Various studies have shown that adopting intensive lipid-lowering therapy within 10 days of an acute coronary event reduces the risk to a greater extent when compared to non-intensive regimens. In this regard, it is important not only to achieve therapeutic targets based on risk profiles and preventive measures but also to implement the most intensive therapeutic regimen possible. […] The pharmacological approach utilizing currently available lipid-lowering drugs involves a stepwise strategy to achieve the defined LDL target, based on the designated risk category. The same guidelines provide the absolute reductions in LDL levels that can be achieved with different therapeutic approaches: the estimated average LDL level reduction ranges from 30% with moderate-intensity statin therapy to 50% with high-intensity statin therapy, and up to 65% with the addition of ezetimibe.

• #2 Hyperlipidemia: Drugs for Cardiovascular Risk Reduction in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0115/p78.html

  The addition of niacin demonstrated significant harm in a recent randomized controlled trial, and its use is no longer recommended. […] In patients with chronic kidney disease who do not require dialysis, statin therapy reduces the risk of major cardiovascular events (NNT = 16 to 25), all-cause mortality (NNT = 36 to 124), and cardiovascular mortality (NNT = 56 to 116). […] Moderate- to high-intensity statin therapy should be recommended for primary prevention in patients with stage 3b or more severe chronic kidney disease.

• #2 How to manage blood cholesterol in primary and secondary prevention

  https://www.escardio.org/Education/Practice-Tools/CVD-prevention-toolbox/how-to-manage-blood-cholesterol-in-primary-secondary-prevention

  Low-density lipoprotein cholesterol (LDL-C) is causal of atherosclerotic cardiovascular disease, the leading cause of morbidity and mortality worldwide. Pharmacologic LDL-C lowering halts the progression of atherosclerosis and improves clinical outcomes in primary as well as secondary prevention. […] According to meta-analyses of randomized trials of LDL-C-lowering medications, the greater the LDL-C reduction, the greater the reduction in the risk of major cardiovascular (CV) events. […] Lifestyle interventions (nutrition; body weight reduction if applicable; physical activity) generally represent the first-line intervention. Lipid-modifying drugs on top of lifestyle interventions are recommended for selected persons in primary prevention (i.e. without known ASCVD) and for essentially all patients in secondary prevention (i.e. patients with known ASCVD).

• #2 What doctors wish patients knew about high cholesterol | American Medical Association

  https://www.ama-assn.org/delivering-care/hypertension/what-doctors-wish-patients-knew-about-high-cholesterol

  Usually addressing those problems outside of your cholesterol is where you would put your focus if somebody had elevated triglycerides, he added. […] The amount of cholesterol that you eat, doesn’t actually impact your own cholesterol very much, she noted. And that’s because your body is making cholesterol. It makes cholesterol no matter what. Even if you eat no cholesterol, your body makes cholesterol. […] If you have high cholesterol with a low cardiovascular risk, you don’t necessarily need to reduce your cholesterol. […] Now, if you have high cholesterol and your cardiovascular risk is low, that’s when you really need to focus on diet and exercise modifications to reduce your overall cardiovascular risk, he added. […] For most people who have moderate to high risk for heart attacks and strokes, the best thing that we can do to both impact their cholesterol levels and impact their overall risk for stroke and heart attack is start a statin medication, said Dr. Kirley.

• #2 New Treatment Guidelines for High Cholesterol: What You Should Know | Brown University Health

  https://www.brownhealth.org/be-well/new-treatment-guidelines-high-cholesterol-what-you-should-know

  Prevention experts are in agreement about cholesterol. […] A healthy diet and lifestyle will reduce your risk. […] If you have ASCVD already, a high intensity statin is recommended to reduce your bad LDL-cholesterol (LDL-C) by at least 50 percent, which will reduce your risk of heart attack by that same amount. […] If you have diabetes and are age 40-75, a moderate or high intensity statin is recommended to reduce your risk. […] If you have very high LDL-cholesterol of greater than 190 mg/dl at age 20 or older, a high-intensity statin is recommended to lower LDL-cholesterol (LDL-C) by 50 percent and to under 100 mg/dl. […] In children ages 0-19, if FH is diagnosed, a statin along with diet and exercise can be safely started at age 10 to reduce future risk. […] If you don’t have any of the above but are age 20-39, it is now recommended that you estimate your 10-year risk of ASCVD using the free ASCVD Plus Risk Estimator or ask your primary care provider to estimate your risk.

• #2 Low-density lipoprotein cholesterol-lowering therapy in the primary prevention of cardiovascular disease – UpToDate

  https://www.uptodate.com/contents/low-density-lipoprotein-cholesterol-lowering-therapy-in-the-primary-prevention-of-cardiovascular-disease

  For patients with LDL-C <190 mg/dL (4.9 mmol/dL) and a 10-year risk between 5 and 7.5 percent, we undertake shared decision-making with the patient, including a detailed discussion of the potential benefits and costs/risks. [...] For patients with LDL-C <190 mg/dL (4.9 mmol/dL) and a 10-year risk less than 5 percent, we do not start statin therapy. [...] Our approach to LDL-C lowering is summarized in an algorithm. [...] The LDL-C should be measured four to six weeks after initiating statin therapy in order to assess LDL-C lowering and statin adherence. If LDL-C reduction has not been achieved, we assess adherence and consider adjusting therapy. [...] In patients in these high- and very high-risk categories, we will subsequently adjust treatment if the patient has not achieved adequate LDL-C lowering. [...] In the setting of primary prevention, indications for nonstatin treatment include the following: For patients who are statin intolerant, or those who are unwilling to start a statin due to fear of side effects, use of nonstatin agents can be an alternative.

• #2 Guidelines for the Management of High Blood Cholesterol – Endotext – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK305897/

  In patients with diabetes mellitus aged 40 to 75 years with an LDL-C 70 mg/dL (1.8 mmol/L), without concomitant ASCVD, begin moderate-intensity statin therapy. […] Initiation of primary prevention should begin with a clinician-patient risk discussion. […] The 2018 guidelines defined very high risk of future ASCVD events as a history of multiple ASCVD events or one major event plus multiple high-risk conditions. […] 2018 guidelines allow consideration of PCSK9 inhibitor as an add-on drug if patients are at very high risk for future ASCVD events and have an LDL-C 70 mg/dL (or non-HDL-C 100mg/dL) during treatment with maximally tolerated statin plus ezetimibe. […] The sooner the LDL-C level is lowered the better the prevention of cardiovascular events. […] Lowering LDL-C levels by lifestyle changes early in life will have long-term benefits.

• #2 High cholesterol – symptoms, causes and levels – BHF

  https://www.bhf.org.uk/informationsupport/risk-factors/high-cholesterol

  There is lots you can do to help lower your cholesterol: try ways of getting more active, which will help lower your cholesterol but also help you sleep better and feel more energetic; cut down on alcohol and stop smoking; enjoy trying healthy foods and recipes that are good for your heart. […] If lifestyle changes are not enough to lower your high cholesterol, your doctor may suggest medication. If you are diagnosed with high cholesterol, your GP should invite you for a blood test every year to check your levels and adjust your treatment if necessary.

• #2 Functional Medicine High Cholesterol Protocol

  https://www.rupahealth.com/post/functional-medicine-high-cholesterol-protocol

  The Mediterranean and DASH diets are evidence-based approaches for promoting cardiovascular health. […] Exercise benefits for heart health include: Weight management, Improved metabolism, Reducing ASCVD risk. […] Statin pharmacologic therapy is often considered the first-line treatment in patients with LDL-C greater than 190 mg/dL, diabetes mellitus, 40-75 years of age, and at sufficient ASCVD risk. […] Personalized supplementation strategies can complement lifestyle modifications and medications. […] If hormonal imbalances are implicated in high cholesterol levels, they must be addressed. […] Prioritize interventions based on the severity of high cholesterol, always emphasizing lifestyle modifications as first-line therapies. […] Regularly monitor progress by tracking lipid panels, assessing adherence to the treatment plan, and evaluating potential side effects of medications/supplements.

• #2

  https://www.nbcnews.com/health/health-news/millions-unaware-heart-attacks-strokes-cholesterol-prevention-rcna135654

  Doctors are increasingly calling for screening for lipoprotein(a), a kind of cholesterol that can lead to deadly heart attacks by middle age. […] Routine blood cholesterol tests could look for Lp(a) but do not largely because there is no effective treatment for it. […] But with several promising drugs making their way through clinical trials, doctors say people should be aware of their risk. […] Dr. Erin Michos said screening for Lp(a) is part of her preventive care for patients. […] „I measure it in all my patients at least once to just find out who’s high because we can do things to lower their risk.” […] Cardiologist Dr. Sahil Parikh believes there should be wider testing for Lp(a). […] „I used to not test for things that I couldn’t treat. But now I do, because I know on the horizon, we’re going to have good treatments. It gives patients hope.”

• #2 ACC-AHA cardiovascular prevention guidelines drop cholesterol treatment goals | MDedge

  https://blogs.the-hospitalist.org/content/acc-aha-cardiovascular-prevention-guidelines-drop-cholesterol-treatment-goals

  „The idea was that certain groups such as those with [a prior atherosclerotic event] and those with very high LDL-cholesterol, especially these familial forms … benefit most, if they can tolerate it, from high-intensity statin therapy.” […] Often, the use of a specific target might lead to undertreatment in certain groups, or overtreatment when, for example, additional medications that are not proven to add incremental or additional benefit are added to treatment. Rather than supporting a target, the data indicated that clinicians „use the appropriate intensity of statin therapy to reduce this atherosclerotic risk in those most likely to benefit,” and that nonstatin therapies „didnt provide an acceptable CVD risk reduction benefit compared to their adverse effects in the routine prevention of heart attack and stroke,” Dr. Stone noted.

• #2 Cholesterol-Lowering Strategies for Cardiovascular Disease Prevention: The Importance of Intensive Treatment and the Simplification of Medical Therapy

  https://www.mdpi.com/2077-0383/13/7/1882

  It is clear from the abovementioned information that new intervention strategies should be based not only on achieving the lowest LDL level but also on the early initiation of treatment, especially in the presence of specific conditions and clinical phenotypes. Particularly in patients at very high risk, starting lipid-lowering therapy directly with the statin + ezetimibe combination could be advantageous. […] A useful strategy to promote therapeutic adherence is the use of a single pill containing various pharmacological agents targeting the control of multiple risk factors or disease mechanisms. A systematic literature review including nine randomized clinical trials highlighted that a polypill containing at least one antihypertensive and one lipid-lowering agent was associated with 33% higher therapeutic adherence compared to standard therapy.

• #2 The Future of Heart Health: UNM Researcher Develops Vaccine to Lower Cholesterol | UNM HSC Newsroom

  https://hscnews.unm.edu/news/the-future-of-heart-health-unm-researcher-develops-vaccine-to-lower-cholesterol

  In the animals that we vaccinated, we see strong reductions in cholesterol levels up to 30% and that is going to be correlated with reduced risk of heart disease. […] Chackerian said his team continues to work hard on making that impact. […] We hope to have a vaccine in people in the next 10 years, he said.

• #2 High Cholesterol

  https://cms.illinois.gov/benefits/stateemployee/bewell/healthcareresources/high-cholesterol.html

  High cholesterol is a condition that can be managed and prevented with the proper steps. […] High cholesterol contributes to a higher risk of cardiovascular diseases, such as heart disease and stroke, but is controllable and high cholesterol can be lowered. […] Since high cholesterol shows almost no symptoms, its important to be educated on how to deal with and prevent it. […] Be Well Illinois wants to help you in the prevention and management of high cholesterol by making sure you have the right tools to know everything about this disease. […] https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia

• #2 Cholesterol | What We Do | World Heart Federation

  https://world-heart-federation.org/what-we-do/cholesterol/

  Although medication such as statins can help control excess cholesterol or its potentially damaging impacts, lifestyle and genetics also play a role, so staying informed about risk factors is a major first step. […] Controlling your cholesterol may be easier than you think, but it all starts with getting your cholesterol checked. […] Although high cholesterol can be easily reduced or treated with inexpensive and cost-effective medications, these treatments remain inaccessible to broad segments of the worlds population.

• #2 High cholesterol – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800

  High cholesterol can be inherited. That means it can pass from parents to children through genes. But high cholesterol often is the result of lifestyle choices such as not getting enough exercise, not eating a balanced diet or consuming large amounts of saturated fat. You can make changes to help prevent it. And if you have high cholesterol, you can help lower it with a healthy diet, regular exercise and sometimes medicine. […] The same heart-healthy lifestyle changes that can lower cholesterol also can help prevent high cholesterol. You can practice the following habits: Eat a diet that focuses on lean protein, fruits, vegetables and whole grains. Limit sodium and added sugar. Also limit the amount of saturated and trans fats you eat. Instead, eat foods with healthy fats such as fatty or oily fish, nuts, and olive or canola oil. Lose extra weight and keep it off. If you smoke, ask your care team to help you quit. Exercise on most days of the week for at least 30 minutes. Drink less alcohol, if at all. Limit alcohol to no more than up to one drink a day for women and up to two drinks a day for men.

• #2 Cholesterol | What We Do | World Heart Federation

  https://world-heart-federation.org/what-we-do/cholesterol/

  High cholesterol causes 3.6 million deaths every year. […] A healthy diet, regular exercise and medication can help reduce high cholesterol. […] High blood cholesterol is one of the major controllable risk factors for heart disease, heart attack and stroke. […] High cholesterol can be inherited, but its often the result of unhealthy lifestyle choices, such as inactivity, smoking and an unhealthy diet. […] The same heart-healthy lifestyle changes that can lower your cholesterol can help prevent you from having high cholesterol in the first place. This includes: Eating a low-salt diet that emphasizes fruits, vegetables and whole grains, Limiting the amount of animal fats and use good fats in moderation, Maintaining a healthy body weight, Quitting smoking, Getting plenty of physical activity (at least 30 minutes every day), Drinking alcohol in moderation, if at all, Managing your stress levels.

• #3 Managing cholesterol | Heart and Stroke Foundation

  https://www.heartandstroke.ca/heart-disease/risk-and-prevention/condition-risk-factors/managing-cholesterol

  High blood cholesterol is one of the major controllable risk factors for coronary heart disease, heart attack and stroke. […] As your blood cholesterol rises, so does your risk of coronary heart disease. […] Making some lifestyle changes is a positive way to control your blood cholesterol levels. […] Heart Stroke recommends that you: […] 1. Eat a healthy balanced diet. […] 2. Cook and eat more meals at home […] 3. Make eating out a special occasion […] 4. Achieve and maintain a healthy weight […] 5. Maintain physical activity […] 6. Be smoke-free. […] Sometimes diet and exercise are not enough to lower your blood cholesterol levels. Several drugs are available to lower your blood cholesterol. Your doctor may prescribe medications to including statins and other cholesterol lowering medication. […] These medications do not cure high blood cholesterol or replace a healthy lifestyle.

• #3 High cholesterol? Here’s what to do about it | UCLA Health

  https://www.uclahealth.org/news/article/high-cholesterol-heres-what-you-can-do-about-it

  Cholesterol is essential for healthy cells and is a building block of hormones, but too much of it increases the risk of heart attack and stroke. The Centers for Disease Control and Prevention (CDC) recommends adults have a cholesterol screening every four to six years. […] About 38% of American adults have high cholesterol, according to the CDC. […] Other ways to reduce cholesterol include prescription-level fibrates, niacin and omega-3 fatty acids. Health care providers consider an individuals age, overall health and cardiovascular risk factors when deciding whether to prescribe cholesterol-lowering drugs. […] However, medicine isnt the only route to better cholesterol numbers. Dietary changes can have a marked impact on cholesterol levels, says Dr. Ko, medical director of the UCLA Health Integrative Medicine Collaborative.

• #3 How to Lower Cholesterol with Diet: MedlinePlus

  https://medlineplus.gov/howtolowercholesterolwithdiet.html

  Cholesterol is a waxy, fat-like substance that’s found in all the cells in your body. Your body needs some cholesterol to work properly. But if you have too much of it in your blood, it can stick to the walls of your arteries and narrow or even block them. This puts you at risk for coronary artery disease and other heart diseases. […] The main treatments for high cholesterol are heart-healthy lifestyle changes and medicines. The lifestyle changes include healthy eating, weight management, and regular physical activity. […] Heart-healthy lifestyle changes include a diet to lower your cholesterol. […] You should limit both total fat and saturated fat. No more than 25 to 35% of your daily calories should come from dietary fats, and less than 7% of your daily calories should come from saturated fat.

• #3 11 Foods that Lower Cholesterol – Harvard Health Publishing – Harvard Health

  https://www.health.harvard.edu/heart-health/11-foods-that-lower-cholesterol

  Changing what foods you eat can lower your cholesterol and improve the armada of fats floating through your bloodstream. Adding foods that lower LDL, the harmful cholesterol-carrying particle that contributes to artery-clogging atherosclerosis, is the best way to achieve a low cholesterol diet. […] Different foods lower cholesterol in various ways. Some deliver soluble fiber, which binds cholesterol and its precursors in the digestive system and drags them out of the body before they get into circulation. Some give you polyunsaturated fats, which directly lower LDL. And some contain plant sterols and stanols, which block the body from absorbing cholesterol. […] A largely vegetarian „dietary portfolio of cholesterol-lowering foods” substantially lowers LDL, triglycerides, and blood pressure. The key dietary components are plenty of fruits and vegetables, whole grains instead of highly refined ones, and protein mostly from plants. Add margarine enriched with plant sterols; oats, barley, psyllium, okra, and eggplant, all rich in soluble fiber; soy protein; and whole almonds.

• #3

  https://www2.hse.ie/conditions/high-cholesterol/prevention/

  Being active and exercising regularly will increase the levels of HDL in your body. […] Exercise will also help you maintain a healthy weight, and lose weight if you’re overweight. […] Doing 150 minutes of moderate-intensity exercise every week is recommended to help lower your cholesterol. […] Try to: avoid drinking more than the recommended weekly units – 11 standard drinks for women and 17 standard drinks for men […] have several drink-free days each week […] avoid drinking lots of alcohol in a short time (binge drinking).

• #3 Prevention and Treatment of High Cholesterol | Texas Heart and Vascular

  https://thandv.com/blog/entry/prevention-and-treatment-of-high-cholesterol-hyperlipidemia-know-your-numbers-and-what-to-do-about-them

  From a dietary standpoint, the best way to lower your cholesterol is reduce saturated fat and trans-fat. The American Heart Association recommends limiting saturated fat to 5 to 6 percent of daily calories and minimizing the amount of trans fat you eat. […] A heart-healthy diet emphasizes fruits, vegetables, whole grains, poultry, fish and nuts, while curbing sugary foods and beverages. Eating this way may also help to increase your fiber intake, which is beneficial. A diet high in fiber can help lower cholesterol levels by as much as 10 percent. […] A sedentary lifestyle lowers HDL (good) cholesterol. Less HDL means there’s less good cholesterol to remove LDL (bad) cholesterol from your arteries. Physical activity is important. Just 150 minutes of moderate-intensity aerobic exercise a week is enough to lower both cholesterol and high blood pressure. […] Smoking lowers HDL (good) cholesterol. […] Being overweight or obese tends to raise LDL (bad) cholesterol and lower HDL (good) cholesterol. Losing excess weight can improve your cholesterol levels. A weight loss of as little as 10 percent can help to improve your high cholesterol numbers.

• #3 10 Natural Ways to Lower Your Cholesterol Levels

  https://www.healthline.com/nutrition/how-to-lower-cholesterol

  Excess weight or obesity can increase your risk of developing high cholesterol levels. Losing weight, if one has excess weight, can help lower ones cholesterol levels. […] Smoking tobacco increases the risk of heart disease in several ways, including increasing LDL and decreasing HDL. […] According to a 2018 research review, clinical studies show that taking 1.53 grams of plant sterols or stanols daily can reduce LDL concentration by 7.512%. […] Unsaturated fats, soluble fiber, and plant sterols or stanols can increase good HDL and decrease bad LDL. Exercise and weight loss can also help.

• #3 High Cholesterol: Causes, Diagnosis, and Treatments | AHN

  https://www.ahn.org/services/cardiovascular/conditions/high-cholesterol

  prevent high cholesterol by eating healthy, exercising and cutting out smoking and alcohol […] Our team of cardiovascular experts, dietitians, and exercise physiologists help manage your cholesterol levels and significantly reduce the long-term risk of heart disease and stroke with medications and support for healthier lifestyles. […] There are high cholesterol medications you can take to help lower cholesterol levels. […] However, making a few lifestyle changes can also help improve your cholesterol. These changes include: […] Reducing foods high in saturated fats, like red meat and dairy products, can help lower your LDL cholesterol. […] Incorporating at least 30 minutes of exercise every day can help raise your HDL (good) cholesterol levels and lower your triglyceride levels. […] Quitting smoking and avoiding tobacco products can help improve your HDL cholesterol levels. […] Cutting down on the amount of alcohol you consume can help lower your cholesterol levels and help prevent heart disease overall.

• #3 A practical approach to the cholesterol guidelines and ASCVD prevention | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/5_suppl_1/15

  Lifestyle factors remain the bedrock of atherosclerotic cardiovascular disease (ASCVD) prevention. Statins remain the first-line therapy for primary and secondary prevention of ASCVD. Physicians are encouraged to discuss the risks and benefits of statins with patients before beginning therapy. Nonstatins and proprotein convertase subtilisin-kexin type 9 inhibitors are recommended for secondary prevention in patients with clinical ASCVD. For patients at intermediate risk of ASCVD, new risk-enhancing factors, including chronic inflammatory conditions and ethnicity, should be considered to better risk stratify these patients. […] High low-density lipoprotein cholesterol (LDL-C) levels warrant intervention. […] Statins are the first-line therapy for lowering LDL-C and preventing ASCVD. […] High LDL-C warrants statin therapy. In addition to unfavorable lifestyle factors, high LDL-C is a known risk factor for ASCVD and it warrants intervention. Regardless of age, patients with LDL-C greater than 190 mg/dL should be started on a statin therapy.

• #3 New Treatment Guidelines for High Cholesterol: What You Should Know | Brown University Health

  https://www.brownhealth.org/be-well/new-treatment-guidelines-high-cholesterol-what-you-should-know

  Prevention experts are in agreement about cholesterol. […] A healthy diet and lifestyle will reduce your risk. […] If you have ASCVD already, a high intensity statin is recommended to reduce your bad LDL-cholesterol (LDL-C) by at least 50 percent, which will reduce your risk of heart attack by that same amount. […] If you have diabetes and are age 40-75, a moderate or high intensity statin is recommended to reduce your risk. […] If you have very high LDL-cholesterol of greater than 190 mg/dl at age 20 or older, a high-intensity statin is recommended to lower LDL-cholesterol (LDL-C) by 50 percent and to under 100 mg/dl. […] In children ages 0-19, if FH is diagnosed, a statin along with diet and exercise can be safely started at age 10 to reduce future risk. […] If you don’t have any of the above but are age 20-39, it is now recommended that you estimate your 10-year risk of ASCVD using the free ASCVD Plus Risk Estimator or ask your primary care provider to estimate your risk.

• #3 Treatment for High Cholesterol

  https://www.everydayhealth.com/high-cholesterol/guide/treatment/

  ACL inhibitors work by blocking the production of cholesterol in the liver. […] They are used as a primary prevention of high cholesterol in individuals with heterozygous familial hypercholesterolemia (FH). […] Although the data doesnt support the ability of the following drugs to directly lower LDL and total cholesterol, your doctor may also prescribe these drugs to manage your triglyceride levels. […] Niacin is a B vitamin that can raise HDL cholesterol while lowering levels of total cholesterol, LDL cholesterol, and triglycerides by limiting your livers ability to produce cholesterol. […] In large doses, omega-3 fatty acids can help lower triglyceride levels.

• #3 A practical approach to the cholesterol guidelines and ASCVD prevention | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/5_suppl_1/15

  The new extensive list of risk enhancers should be considered to risk stratify and tailor treatment in patients with an intermediate risk of ASCVD. […] Finally, there is new guidance about the role of non-statin agents, such as ezetimibe and proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, in secondary prevention. Very high risk of ASCVD exists in patients with a clinical history of a major atherosclerotic event, recent ASCVD, myocardial infarction, or ischemic stroke. These high-risk patients should have an LDL-C less than 70 mg/dL, though the Endocrine Society recommends LDL-C less than 55 mg/dL in patients diabetes and high-risk features for ASCVD. […] Statins remain the first-line drugs for lowering cholesterol and ASCVD risk reduction.

• #3 New Treatment Guidelines for High Cholesterol: What You Should Know | Brown University Health

  https://www.brownhealth.org/be-well/new-treatment-guidelines-high-cholesterol-what-you-should-know

  If you don’t have any of the above but are age 40-75, it is recommended that you calculate your 10-year risk of ASCVD using the free ASCVD Plus Risk Estimator. […] If your calculated 10-year risk is between 5 and 7.5 percent, consider a statin if you have „risk-enhancing” factors. […] If your calculated 10-year risk is between 7.5 and 20 percent, a statin is recommended. […] If your calculated 10-year risk is 20 percent or greater, a high intensity statin is recommended to lower LDL-C by at least 50 percent.

• #3 How to manage blood cholesterol in primary and secondary prevention

  https://www.escardio.org/Education/Practice-Tools/CVD-prevention-toolbox/how-to-manage-blood-cholesterol-in-primary-secondary-prevention

  Briefly, in primary prevention, drug treatment is to be considered in individuals at low or moderate high CV risk if LDL-C levels are 4.9 mmol/l or 2.6 mmol/l, respectively, and are uncontrolled despite lifestyle interventions. […] For individuals in primary prevention at very high risk, drug treatment is recommended in the presence of LDL-C levels 1.8 mmol/l. […] Thereby, in the context of secondary prevention, drug treatment is recommended for all patients with LDL-C 1.8mmol/l, and is to be considered even at lower LDL-C levels. […] Current European guidelines recommend the use of treatment targets, which are dependent on each individual’s total CV risk level. […] Statins represent the first-line treatment for LDL-C lowering, in view of the extensive evidence regarding their clinical efficacy and safety. Statins should be given up to the highest tolerable dose in order to reach the LDL-C goal for any given individual.

• #3 Low-density lipoprotein cholesterol-lowering therapy in the primary prevention of cardiovascular disease – UpToDate

  https://www.uptodate.com/contents/low-density-lipoprotein-cholesterol-lowering-therapy-in-the-primary-prevention-of-cardiovascular-disease

  We start statin therapy for older-aged patients in whom LDL-C lowering is deemed appropriate by the above-outlined criteria. Statin therapy lowers the risk of stroke and myocardial infarction in older adult patients; the relative risk reduction may be smaller, but the absolute risk reduction is larger because of the high absolute risk among older versus younger patients.

• #3 ACC-AHA cardiovascular prevention guidelines drop cholesterol treatment goals | MDedge

  https://blogs.the-hospitalist.org/content/acc-aha-cardiovascular-prevention-guidelines-drop-cholesterol-treatment-goals

  „These guidelines are based on an objective review of the evidence and that evidence is clear: There is no evidence for treating to specific target numbers for cholesterol. Yet, there is clear and strong evidence for the use of statin medications for people at elevated risk for heart disease and stroke,” he said. […] „The new treatment approach is more patient centered; it is about treating those who are most likely to benefit from taking a chronic medication; it is about reducing their risk with proven medicines; and it also reduces patient burden by lessening the need for repeat testing and taking additional, unproven medications,” he said in an interview.

• #3 Cholesterol-Lowering Strategies for Cardiovascular Disease Prevention: The Importance of Intensive Treatment and the Simplification of Medical Therapy

  https://www.mdpi.com/2077-0383/13/7/1882

  It is clear from the abovementioned information that new intervention strategies should be based not only on achieving the lowest LDL level but also on the early initiation of treatment, especially in the presence of specific conditions and clinical phenotypes. Particularly in patients at very high risk, starting lipid-lowering therapy directly with the statin + ezetimibe combination could be advantageous. […] A useful strategy to promote therapeutic adherence is the use of a single pill containing various pharmacological agents targeting the control of multiple risk factors or disease mechanisms. A systematic literature review including nine randomized clinical trials highlighted that a polypill containing at least one antihypertensive and one lipid-lowering agent was associated with 33% higher therapeutic adherence compared to standard therapy.

• #3 Prevention and Treatment of High Cholesterol – Making India HeartStrong!

  https://makingindiaheartstrong.com/blog/prevention-and-treatment-of-high-cholesterol/

  Having your cholesterol checked Even if your risk of developing heart disease is low, this is important. […] Eat healthy – For high cholesterol prevention. […] Staying physically active – Getting at least 150 minutes of moderate-intensity aerobic activity is necessary. […] Living tobacco-free – It’s important to quit smoking if you have high cholesterol. […] Individuals should see their healthcare provider on a regular basis to undergo screenings and blood tests and know their cholesterol numbers.

• #3 Treat and Manage High Cholesterol | Cholesterol | CDC

  https://www.cdc.gov/cholesterol/treatment/index.html

  High cholesterol often is treated and managed by a combination of adjusting certain lifestyle factors and taking cholesterol-lowering medicines prescribed by a doctor. […] You can take steps to lower your LDL cholesterol levels by making healthy changes to your lifestyle, such as choosing foods lower in saturated and trans fats and maintaining a healthy weight. […] You and your health care team can work together to prevent or treat other health conditions and ensure that they don’t lead to high LDL cholesterol. […] You may need to have your cholesterol levels tested at least once every 4 to 6 years if you do not have heart disease.

• #3 Cholesterol Management | Million Hearts®

  https://millionhearts.hhs.gov/about-million-hearts/optimizing-care/cholesterol-management.html

  Optimal cholesterol management is an important part of reducing atherosclerotic cardiovascular disease (ASCVD). […] For people with high LDL cholesterol levels or for others at high risk for having an ASCVD event in the next 10 years, experts recommend lifestyle changes and cholesterol-lowering medications to lower ASCVD risk. […] Recommended treatment for FH includes healthy lifestyle choices and statin therapy, started early and continued with close follow-up to reach treatment goals. […] The 39.1 million people who are at high risk for an ASCVD event but are not taking a statin could reduce their risk of a heart attack or stroke by up to half if therapy were taken regularly. […] The 2018 ACC/AHA guidelines state that very high-risk individuals who have suboptimal LDL levels after maximal doses of statins may also benefit from additional medications.

• #3 Cholesterol-Lowering Strategies for Cardiovascular Disease Prevention: The Importance of Intensive Treatment and the Simplification of Medical Therapy

  https://www.mdpi.com/2077-0383/13/7/1882

  It is evident that, in dyslipidemic patients at risk of developing cardiovascular pathologies, it is advisable to apply intensive lipid-lowering treatment while ensuring maximum therapeutic adherence. A recent study has evaluated the joint contribution of treatment intensity and adherence to prescribed therapy on cardiovascular events in patients with dyslipidemia and established cardiovascular risk factors or diseases, in which the association of both factors with a reduction in cardiovascular risk was confirmed, mediated by reduced LDL levels. […] Lipid-lowering therapy has been shown to be effective in preventing cardiovascular disease; however, reluctance to prescribe an intensive regimen and limited adherence to treatment still pose significant barriers to therapeutic optimization. Considering the ongoing high epidemiological impact of cardiovascular diseases and high mortality rates globally, it is essential to implement treatment strategies through the use of pharmacological combinations (e.g., moderate-intensity statins + ezetimibe) to improve therapeutic adherence and reduce the burden of atherosclerotic risk.

• #4 How to Lower Cholesterol with Diet: MedlinePlus

  https://medlineplus.gov/howtolowercholesterolwithdiet.html

  Instead of saturated fats, switch to foods with healthier fats, such as lean meat, nuts, and unsaturated oils like canola, olive, and safflower oils. […] If you are trying to lower your cholesterol, you should have less than 200 mg a day of cholesterol. […] Soluble fiber helps prevent your digestive tract from absorbing cholesterol. You should try to get 10 to 25 grams of it per day. […] Increase plant stanols and sterols in your diet. These are substances that also help prevent your digestive tract from absorbing cholesterol. […] These special fats can lower LDL and triglyceride levels. […] You should try to limit the amount of sodium (salt) that you eat to no more than 2,300 milligrams (about 1 teaspoon of salt) a day. […] Limiting salt won’t lower your cholesterol, but it can lower your risk of heart diseases by helping to lower your blood pressure. […] Alcohol adds extra calories, which can lead to weight gain. Being overweight can raise your LDL level and lower your HDL level. Too much alcohol can also increase your risk of heart diseases because it can raise your blood pressure and triglyceride level.

• #4 Prevention and Treatment of High Cholesterol | Texas Heart and Vascular

  https://thandv.com/blog/entry/prevention-and-treatment-of-high-cholesterol-hyperlipidemia-know-your-numbers-and-what-to-do-about-them

  From a dietary standpoint, the best way to lower your cholesterol is reduce saturated fat and trans-fat. The American Heart Association recommends limiting saturated fat to 5 to 6 percent of daily calories and minimizing the amount of trans fat you eat. […] A heart-healthy diet emphasizes fruits, vegetables, whole grains, poultry, fish and nuts, while curbing sugary foods and beverages. Eating this way may also help to increase your fiber intake, which is beneficial. A diet high in fiber can help lower cholesterol levels by as much as 10 percent. […] A sedentary lifestyle lowers HDL (good) cholesterol. Less HDL means there’s less good cholesterol to remove LDL (bad) cholesterol from your arteries. Physical activity is important. Just 150 minutes of moderate-intensity aerobic exercise a week is enough to lower both cholesterol and high blood pressure. […] Smoking lowers HDL (good) cholesterol. […] Being overweight or obese tends to raise LDL (bad) cholesterol and lower HDL (good) cholesterol. Losing excess weight can improve your cholesterol levels. A weight loss of as little as 10 percent can help to improve your high cholesterol numbers.

• #4 What doctors wish patients knew about high cholesterol | American Medical Association

  https://www.ama-assn.org/delivering-care/hypertension/what-doctors-wish-patients-knew-about-high-cholesterol

  A statin medication changes the way cholesterol is metabolized in your body so that you ultimately have lower levels of cholesterol circulating in your bloodstream, particularly that LDL cholesterol that we worry about. […] For a risk of 7.5% to 19%, we really think they need a medicine, and we’ll try to recommend that. […] There is an entire other category that we look at, which is secondary prevention and that is after a person has had such an event, statins already have been prescribed to prevent secondary events. […] But having other health conditions can definitely impact your cholesterol levels, she said. […] It is important to note that high cholesterol and high blood pressure tend to run together, said Dr. Kirley. […] We see that increasing physical activity and eating a generally more healthful diet can be helpful for cholesterol levels, but these changes tend to have a relatively small impact on cholesterol levels, she said.

• #4 High Cholesterol Symptoms: Risks and Treatment

  https://www.verywellhealth.com/high-cholesterol-symptoms-697596

  If lifestyle modifications are not enough to bring your high cholesterol under control, your healthcare provider may prescribe cholesterol-lowering drugs. Options include: Statin drugs like Lipitor (atorvastatin) and Crestor (rosuvastatin), Bile acid-binding resins like Welchol (colesevelam) and Colestid (colestipol), PCSK9 inhibitors like Praluent (alirocumab), Repatha (evolocumab), and Leqvio (inclisiran), Nexletol (bempedoic acid), an ATP citrate lyase (ACL) inhibitor, Zetia (ezetimibe), a cholesterol absorption inhibitor. […] In addition to cholesterol-lowering drugs like statins, certain lifestyle changes can help lower your cholesterol whether you are on treatment or not. These include: Eating a diet low in saturated fat and trans fat, Doing 150 minutes of moderate-aerobic exercise per week, Losing weight if you are overweight or obese, Quitting cigarettes.

• #4 Hyperlipidemia: Drugs for Cardiovascular Risk Reduction in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0115/p78.html

  The addition of niacin demonstrated significant harm in a recent randomized controlled trial, and its use is no longer recommended. […] In patients with chronic kidney disease who do not require dialysis, statin therapy reduces the risk of major cardiovascular events (NNT = 16 to 25), all-cause mortality (NNT = 36 to 124), and cardiovascular mortality (NNT = 56 to 116). […] Moderate- to high-intensity statin therapy should be recommended for primary prevention in patients with stage 3b or more severe chronic kidney disease.

• #4

  https://www.nbcnews.com/health/health-news/millions-unaware-heart-attacks-strokes-cholesterol-prevention-rcna135654

  Doctors are increasingly calling for screening for lipoprotein(a), a kind of cholesterol that can lead to deadly heart attacks by middle age. […] Routine blood cholesterol tests could look for Lp(a) but do not largely because there is no effective treatment for it. […] But with several promising drugs making their way through clinical trials, doctors say people should be aware of their risk. […] Dr. Erin Michos said screening for Lp(a) is part of her preventive care for patients. […] „I measure it in all my patients at least once to just find out who’s high because we can do things to lower their risk.” […] Cardiologist Dr. Sahil Parikh believes there should be wider testing for Lp(a). […] „I used to not test for things that I couldn’t treat. But now I do, because I know on the horizon, we’re going to have good treatments. It gives patients hope.”

• #5 HIV and High Cholesterol | NIH

  https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-and-high-cholesterol

  High cholesterol (also called hyperlipidemia) is a complex condition with multiple contributing factors including HIV and certain HIV medicines. […] In people with HIV, treatment for high cholesterol may involve changing an HIV treatment regimen to avoid taking certain HIV medicines that can increase cholesterol levels. […] Cholesterol testing is recommended before and after a person starts taking HIV medicines. […] If you are overweight or obese, losing weight can improve cholesterol levels. […] In people with HIV, treatment for high cholesterol may involve changing an HIV treatment regimen to avoid taking HIV medicines that can increase cholesterol levels.

• #5

  https://www.nbcnews.com/health/health-news/millions-unaware-heart-attacks-strokes-cholesterol-prevention-rcna135654

  The hope is that we can keep them safe until we can get one of these drugs on the market, Nissen, who is an investigator for clinical trials of lepodisiran, said. […] He and other cardiologists are calling for widespread screening of Lp(a). […] „Why wait for those new drugs?” said Michos of Johns Hopkins. Measuring Lp(a) now „identifies a high-risk patient. We can be proactive about prevention. We can take action.” […] That is, maintaining a normal weight, getting regular exercise, stopping smoking and eating a diet rich in fruits, vegetables and whole grains are effective ways of managing heart risks overall, even for people with elevated Lp(a), Michos said. […] Welsh’s mother had the first of three heart attacks in her late 40s. Doctors tested her Lp(a) levels and explained how they greatly elevated her heart risks.

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