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Cholesterol is vital for good health and well-being.

Our body uses cholesterol to make essential vitamins and hormones. Cholesterol is also involved in digestion and is part of many cells in our body. However when the bad cholesterol called LDL is raised, it can lead to blockages in our blood vessels throughout the body, causing stroke and heart disease.

HDL or healthy cholesterol is good for us and helps to remove cholesterol deposits, leading to a less heart disease. A normal level of cholesterol is less than 5.2mmol/L. The LDL or bad cholesterol should be less than 2.6mmol/L and the healthy HDL should be between 1.0 to 1.5 mmol/L. Over 20% of the adult population use a statin to help lower their cholesterol.

This medication works by reducing the conversion of cholesterol in our body. It is effective at lowering the bad LDL cholesterol and may increase the healthy HDL cholesterol. It is also thought that statins can help to reduce our risk of heart disease by lowering inflammation and preventing clots or blockages from forming in the body.

Statins however, are not without their risks. They can cause problems such as muscle ache, gut disturbances and liver problems. In severe cases statins can lead to serious muscle breakdown, particularly if taken with other cholesterol medication called fibrates. When recommending a statin for cholesterol your doctor will conduct a cardiovascular risk assessment.

This includes assessing lifestyle factors such as;

• Smoking

• High blood pressure

• Elevated cholesterol (total or low density lipoprotein)

• Decreased high density lipoprotein cholesterol

• Diabetes

• Obesity (waist measurement and body mass index)

• Lifestyle (physical activity, nutrition, stress and alcohol)

It is important to address these risk factors before starting a statin for cholesterol, however in certain cases a statin may be needed directly to prevent heart disease. It is recommend waiting until after 45 years of age to assess cardiovascular risk in healthy individual, although Aboriginal and Torres Strait Islander people should be assessed from age 35 years.

Strategies you can use to reduce your cholesterol without statins include reducing the amount of saturated and trans fats in your diet. These fats are found mostly in animal foods and processed foods. Increasing your intake of healthy fat from nuts, seeds and fish can all help to reduce your risk of heart disease and lower your cholesterol.

You can also try using a food that has added plant sterols. These are found in some margarines, milk and cheese. They work by reducing the absorption of cholesterol in the gut and may reduce cholesterol by around 10%.

References: Smith, J. 2011 Appropriate primary prevention of cardiovascular disease: does this mean more or less statin use? Aust Prescr, 34:169-72 Rang, HP & Dale, MM. 2007. Rang and Dale’s Pharmacology. Curchill Livingstone Elsevier

29 Feb 2012

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