Your health questions answered: What can I do about high cholesterol?

You ask. OHSU health experts answer. This month, one of our cardiovascular experts is on the hot seat.

Q. I eat healthy, exercise and am not overweight – but I have high cholesterol. What can I do?

A. Average low-density lipoprotein (LDL, or “bad”) cholesterol is below 125; when it is above 160, you may have been born with high cholesterol. Talk to your primary care provider. You may have a genetic condition called familial hypercholesterolemia (FH). People with FH cannot remove low-density LDL cholesterol from their blood, and thus have high levels. The most important thing you should do if you have FH is to scrupulously follow a healthy lifestyle:

  • Exercise regularly.
  • Eat right.
  • Don’t smoke.
  • Keep your weight within a normal range.

If your cholesterol remains high, you may eventually need a statin, a medication that’s very effective in lowering cholesterol. There are also options if you cannot tolerate statins.

For more information, contact the OHSU Knight Cardiovascular Institute’s Heart Disease Prevention Program.

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Dr. Sergio Fazio is Director of the Center for Preventive Cardiology, where he works to prevent and reverse heart disease through personalized care and research innovation. U.S. News & World Report rank the OHSU Knight Cardiovascular Institute as the top cardiology and heart surgery hospital in Oregon.

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Comments

  1. What do you recommend: simvastatin or pravastatin? Or there isn’t too much difference between statins?

  2. Thank you for your question. Simvastatin and pravastatin are drugs of the same class (statins) and with an identical mechanism of action (block production of cholesterol). They are both generic, covered by most insurances, and very inexpensive. They have both shown to be able to reduce heart attacks and stroke in clinical trials. To find differences between the two we need to look at potency of cholesterol reduction (40 mg of simvastatin is more powerful than 40 mg pravastatin) and safety of the compound (pravastatin is less frequently associated with muscle pain). For more information, we recommend reaching out to your health care provider. You can also visit us here: http://www.ohsu.edu/xd/health/services/heart-vascular/getting-treatment/. – Dr. Fazio

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