What are the cholesterol reducing drugs mostly used in familial hypercholesterolemia? What are their benefits? What about the side effect? What is the most important information I should have?
The main goal of cholesterol drug therapy is to reduce your risk for developing atherosclerotic heart disease by lowering the bad “LDL” cholesterol levels in your blood. Atherosclerosis occurs when fatty deposits accumulate along the walls of your arteries, causing them to be thick and hard.
Eventually, these fatty materials or plaques will cause the affected arteries to be blocked; leading to coronary heart diseases, i.e. heart attacks and strokes.
Your doctor will consider prescribing cholesterol reducing drugs for you, if adopting new life style changes, like eating healthy food, having regular physical exercise and losing weight are not enough to lower your blood cholesterol levels.
If your LDL “Bad” cholesterol ranges from 160 to 189mg/dl, then drugs for reducing cholesterol are optional for you, but if your LDL cholesterol is very high, i.e. ≥ 220 mg/dl, your doctor will have to start drug therapy together with therapeutic life style changes (TLC).
In case you are suffering from heart diseases, your doctor will consider starting cholesterol lowering drugs when your LDL levels are ranging from 100 mg/dl to 129 mg/dl.
Your first treatment of choice will be Statins or HMG CoA reductase inhibitors, which include atorvastatin, fluvastatin, rosuvastatin, simvastatin, lovastatin, and pravastatin. Statins are very potent in reducing LDL “bad” cholesterol levels in your blood, besides, their side effects are minimal and short-termed.
Another two classes of cholesterol lowering drugs are niacin (nicotinic acid) and bile acid sequestrants (including colesevelam, cholestyramine and colestipol). Clinically, these 2 groups are proved to lower your high risk of having heart diseases and strokes.
Furthermore, they don’t show any dangerous side effects. Your doctor will prefer niacin if your triglyceride levels are ≥ 250 mg/dl, as bile acid sequestrants seem to increase triglycerides levels in your blood.
Other available medications for lowering your blood cholesterol level are fenofibrate, gemfibrozil, and clofibrate. These are fibric acid derivatives or fibrates; they are used mainly for reducing the elevated levels of triglycerides.
It is an inherited disease which runs through families causing the individual to have elevated levels of LDL “Bad” cholesterol since birth, thus increasing the susceptibility of having heart attacks and strokes at a very young age.
You can inherit this condition if you get the abnormal gene from one of your parents only (autosomal dominant manner). If you inherited one copy of this abnormal gene, then you will have heterozygous familial hypercholesterolemia.
While if you inherited the gene from both of your parents, you will suffer from homozygous familial hypercholesterolemia, which is more severe. In some cases, blood cholesterol levels can reach > 600 mg/dl.
Generally, in familial hypercholesterolemia, this defective gene (on chromosome 19) will make your body unable to eliminate LDL or bad cholesterol from blood circulation, leading to presence of high levels of LDL cholesterol in your blood constantly, so atherosclerosis can develop easily at an early age.
Usually, familial hypercholesterolemia is treated by combination of cholesterol lowering drugs and effective therapeutic lifestyle changes, like eating healthy diet, having regular physical activity and losing weight.
Of course, statins are the most effective drugs of choice. Also, other drugs like bile acid sequestrant (resins), ezetemibe, niacin, gemfibrozil, and fenofibrate can be prescribed in combination with or instead of statins.
Unfortunately, if you are suffering from homozygous familial hypercholesterolemia, the drug therapy will not be enough to lower your extremely elevated blood cholesterol levels; actually.
In this case, your doctor will have to suggest other more aggressive treatments, like periodical cleaning up of LDL cholesterol from your blood (which is known as LDL aphaeresis) or a liver transplant.
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