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Heart Attack

How Cholesterol Management Can Help Prevent Stroke and Heart Disease

Summary & Participants

Each year more than a million Americans have heart attacks. High cholesterol can form a blockage in the arteries and lead to heart disease. Lifestyle changes and adherence to a treatment plan are important for cholesterol management.

Medically Reviewed On: July 21, 2008

Webcast Transcript

ADOLPH M. HUTTER, Jr., MD: Regular exercise is also very important. Even people who are overweight have a better prognosis if they exercise. Control of your blood pressure is important. If you control your blood pressure, you keep those arteries from getting stiffer, and it also helps prevent the progression of those atherosclerotic plaques. And obviously, no smoking.

ANNOUNCER: If lifestyle changes have not lowered your cholesterol enough or if your levels remain high, your doctor may recommend cholesterol lowering drugs, the most common being a class called statins.

ADOLPH M. HUTTER, Jr., MD: These are drugs that work on the metabolism of the liver and lower the bad cholesterol. They lower it tremendously, and there are a lot of randomized trials that have shown that if you use a statin and a diet and lower that LDL to less than 70, you significantly decrease the risk of heart attacks, of strokes, of sudden death, and of death in general. Now, sometimes you're on a statin, you're on a good diet, and you still can't get that LDL low enough. There's another drug called ezetimibe, which works by a different mechanism, and it blocks the absorption of the bad cholesterol in the gut. And that will lower the LDL by an additional 18 percent when given to a person already on a statin.

ANNOUNCER: Doctors may also prescribe bile acid sequestrants, another class of drugs that lower LDL levels by preventing the absorption of cholesterol in the gut. In some instances, though, a patient may require different medications.

ADOLPH M. HUTTER, Jr., MD: If you have a low HDL and high triglycerides, there are other drugs that can help raise the HDL and lower the triglycerides. Niacin, particularly in the long-acting form, like niacin-ER, or Niaspan, have been shown to be very effective in raising the HDL and lowering the triglycerides. There's another category of drugs that raise the HDL, lower the triglycerides, and that's called the fibrates. And they're very effective, and they could also be used in conjunction with the statins.

ANNOUNCER: Once you are on a treatment plan to manage your cholesterol it is important to stick to the plan to help prevent heart attacks and stroke.

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