When you are told that you have high cholesterol, your doctor will probably start you on a statin drug. That is the most common treatment that we know of. But medical science is improving day by day. Today I am going to tell you about some of the latest and most advanced treatments that have come and are coming to control cholesterol. These are like the future of medicine.
Three things we need to know about cholesterol first
Before we talk about new medications, it's very important to keep these three things in mind about cholesterol.
1. Cholesterol is a major culprit in heart disease: Our body cells need some cholesterol. But if it gets too much, it can be very dangerous. This excess cholesterol can build up in our blood vessels (plaque), which can clog them. This is the main cause of heart attacks.
2. There is a treatment for this: Even if cholesterol is deposited inside your blood vessels, there are effective medications today that can reduce and control it.
3. These treatments are safe: These medications are safe and very effective. Sometimes there may be minor side effects, but they can be managed by talking to your doctor. So don't worry.
New drugs that go beyond statins
Statins are the mainstay of cholesterol treatment, but there are now more advanced medications available. Let's take a look at a few of them.
| Type of medicine | Simple operation and important points |
|---|---|
| Ezetimibe (Zetia) | This is a drug that is given in combination with statins. It is now less expensive. It is especially useful for people over the age of 75. This is a good solution for those who have difficulty controlling their cholesterol levels with statins alone. |
| PCSK9 Inhibitors | This is a real game-changer. These are a type of monoclonal antibodies that are given as a vaccine. Simply put, the 'bad' cholesterol in our body, that isLow-density lipoprotein (LDL) needs to go to the liver to be cleaned. But a protein called PCSK9 interferes with the cleaning of this LDL. This drug blocks that PCSK9 protein. Then the liver can clean and remove LDL cholesterol much faster. |
| Inclisiran (Leqvio) | This is like a 'vaccine' for cholesterol. It's a shot that's given every 6 months. It affects a molecule called RNA , which carries information in our genes, and reduces the production of the PCSK9 protein mentioned earlier. That means it's a very targeted treatment. |
| Bempedoic Acid | This is similar to statins, but it affects a different part of the cholesterol production process. It does not cause the muscle pain (myalgia) that occurs with statins. However, it can increase uric acid levels and increase it in people with gout. There is also talk of a risk of tendon rupture. Therefore, it is important to always talk to your doctor when using this medication. |
| Vascepa (Purified Fish Oil) | This is not your average fish oil pill from the pharmacy. This is a special fish oil that a doctor prescribes. It contains only purified EPA . If you are taking statins but your triglyceride levels are still high, this can help reduce your risk of heart attack and stroke. |
Cholesterol from genes (Familial Hypercholesterolemia)
There are some people who, no matter how healthy they eat and exercise, have very high cholesterol levels. The reason for this is a condition that comes from their genes, which is called familial hypercholesterolemia (FH) . For these people, it is difficult to control their cholesterol with standard treatments.
"Why do I always have to blame my cholesterol?" That's something my patients with FH ask all the time. We need to understand that this is not their fault, it's a genetic condition.
Imagine how valuable new drugs like `PCSK9 Inhibitors` are to people like this. Because of those drugs, for the first time in history, people with FH have a successful treatment option.
A little more about the 'cholesterol vaccine'
While some people may like the idea of taking Inclisiran every 6 months, others may be afraid. "Will I be on this medication for 6 months? And if I have side effects, will they last for 6 months?" It's a good idea to ask questions like these. Discuss any concerns or fears you have with your doctor about any medication you take. It's your right.
Medicine alone is not enough! Lifestyle is the key
No matter how much we talk about advanced medicine, there's one thing you should never forget. And that's a healthy lifestyle.
- Diet: It is essential to eat cholesterol-lowering foods (oats, barley, nuts, vegetables, fruits), and avoid processed foods, such as sausages, meatballs, etc. Surveys show that 58% of the food we eat is ultra-processed.
- Exercise: Exercising daily is not only good for cholesterol control, but also for the entire body.
- Smoking and alcohol: Completely avoiding these things is very important for heart health.
Just think, even if you take medication and lower your cholesterol numbers, if you continue to eat unhealthy foods and don't exercise, your risk of developing a heart attack won't decrease that much.
A pill can never replace a healthy lifestyle. The two need to go together.
If you already have heart disease, have had a heart attack, or have had a stent inserted, you don't have time to wait. You need to start taking your medication immediately, as directed by your doctor. You also need to make lifestyle changes.
Take-Home Message
- Cholesterol is a major cause of heart disease. But don't worry, there are effective and safe treatments for it.
- In addition to statins, there are now more advanced, targeted therapies such as PCSK9 inhibitors and Inclisiran.
- If you have a genetic cholesterol condition (FH), this new medication could be a great relief for you.
- If you have any questions about the medication you are taking, be sure to discuss it with your doctor.
- The most important thing: No matter how good the medication is, you can't control your cholesterol without a healthy lifestyle (good diet, exercise). Medication is only a support, the foundation should be your lifestyle.
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