Cholesterol is a lipid (fat) that is necessary
for our bodies to function. Higher than normal levels of cholesterol in the
blood can cause damage to blood vessels by accumulating in the vessel and
forming plaques that can obstruct or block blood
flow and cause narrowing of the blood vessels. High cholesterol (hypercholesterolemia) increases the risk of heart disease and stroke.
Other factors that increase risk of heart disease are smoking, high blood
pressure, diabetes, being overweight, older age, and having a family member
who had a heart attack at a young age. The May 12, 2004, issue of JAMA includes an article about treating high cholesterol levels in
High cholesterol itself does not cause any symptoms, so it is important
to have your cholesterol level checked. The choice of treatment depends on
the level of a person's risk for heart disease in addition to cholesterol
level. There are several options for treating high cholesterol that you should
discuss with your doctor.
Eating a diet rich in fruits and vegetables, low in saturated
fats, and low in total fat content can help to lower cholesterol to healthful
Engaging in regular exercise for at least 30 minutes each day
lowers cholesterol levels and prevents type 2 diabetes, lowers risk of heart
disease, and reduces or maintains weight. Regular physical activity (such
as walking) is a cornerstone of treatment for high cholesterol and related
Losing excess body weight can lower cholesterol levels. Controlling
weight by reducing caloric intake and introducing daily exercise has many
beneficial effects, including reducing risk for diabetes, heart attack, and
Stopping smoking is important because tobacco products damage
blood vessels, making it easier for cholesterol to form plaques.
Medications called statins work in the liver
to block production of cholesterol. These medications are effective in reducing
cholesterol levels, but the levels go up again if the medicine is stopped.
These medicines can have adverse effects that require attention. Liver damage
can occur, as well as muscle damage called myopathy.
Regular laboratory examinations may be required to check for liver damage.
Any muscle pain or weakness that develops while taking a statin medication
must be reported immediately to your doctor. Women who are pregnant or nursing
should not take statin medications.
Sequestering medications (also called binding agents) combine with bile acids in the intestine. This process makes less cholesterol available to go into the bloodstream.
National Heart, Lung, and Blood Institutehttp://www.nhlbi.nih.gov
American Heart Association 800/242-8721http://www.americanheart.org
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on cholesterol
and atherosclerosis was published in the May 16, 2001, issue; one on cholesterol
was published in the January 13, 1999, issue; and one on risk factors for
heart disease was published in the August 20, 2003, issue.
Sources: National Heart, Lung, and Blood Institute; American Heart Association
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
TOPIC: CARDIOVASCULAR DISEASE
Torpy JM, Lynm C, Glass RM. Treatment of High Cholesterol. JAMA. 2004;291(18):2276. doi:10.1001/jama.291.18.2276