Our Specialties

Our care is broad and comprehensive, covering every aspect of heart and vascular health, from prevention to surgical treatment, using state-of-the-art diagnostic technologies, the newest procedures, and medicines available today.

Bringing the future of cardiovascular health to life.

Management of High Cholesterol

Our doctors may prescribe you a cholesterol-lowering statin if you have high levels of total cholesterol or of LDL cholesterol (the “bad cholesterol”) that cannot be lowered with a program of diet and exercise. You may also need to take this type of medicine if you have a  medical condition that causes you to have high cholesterol.

How do cholesterol-lowering medicines work?

There are 5 types of cholesterol-lowering medicines. Each type works differently.

Statins are also called HMG-CoA reductase inhibitors. HMG-CoA reductase is an enzyme that helps your body make cholesterol. Statins help to block this enzyme, which causes your body to make less cholesterol. When cholesterol production is slowed, it signals your liver to make more LDL receptors. These receptors attract the LDL particles in the blood and, in turn, reduce the amount of LDL cholesterol in your bloodstream. Lower LDL levels can lead to lower triglyceride levels and higher HDL (“good cholesterol”) levels.

Bile Acid Sequestrants or Resins. Your body uses cholesterol to make bile, an acid used in the digestive process. These medicines bind to bile, so they cannot be used during digestion. Your liver responds by making more bile. The more bile your liver makes, the more cholesterol it uses. So less cholesterol is left to circulate through your bloodstream.

Nicotinic Acid, or niacin, is a form of vitamin B. It appears to slow the liver’s production of certain chemicals that help to make LDL (“bad”) cholesterol. Nicotinic acid has also been found to lower triglycerides and raise HDL (“good cholesterol”) levels.

Fibric Acid Derivatives or fibrates, are used to lower triglyceride levels. Fibrates break down the particles that make triglycerides and use them in other ways in your body. Lower triglycerides can lead to increased HDL (“good”) cholesterol levels.

Cholesterol Absorption Inhibitors are used to lower LDL (“bad”) cholesterol levels. This medicine can also be given in combination with a statin. Cholesterol absorption inhibitors work in the digestive tract by reducing the amount of cholesterol absorbed from foods you eat. You must stay on a cholesterol-lowering diet while taking this medicine.

PCSK9 Inhibitors are a newer class of FDA-approved medications that lower LDL (“bad”) cholesterol levels. Research indicates that PCSK9 inhibitors are highly effective and can be used alone or in combination with statins. According to guidelines and consensus statements, PCSK9 inhibitors are recommended as second or third-line treatments or as an alternative option for patients unable to tolerate statins, particularly those with atherosclerotic CVD or familial hypercholesterolemia with ongoing high cholesterol levels.

How much do I take?

There are many different kinds of cholesterol-lowering medicines. The amount of medicine you need to take may vary. Talk to your doctor or pharmacist for more information about how and when to take this medicine.

What if I am taking other medicines?

Other medicines that you may be taking can increase or decrease the effect of cholesterol-lowering medicines. These effects are called an interaction. Be sure to tell your doctor about every medicine and vitamin or herbal supplement that you are taking so he or she can make you aware of any interactions.

The following are some of the medicines that can interact with cholesterol-lowering medicines. Because there are so many kinds of medicines within each category, not every type of medicine is listed by name. Tell your doctor about every medicine you are taking, even if it is not listed below.

  • An anticoagulant such as warfarin. If you are taking warfarin and a cholesterol-lowering medicine, your dosages of each may need to be adjusted.
  • Certain antibiotic medicines.
  • Certain antifungal medicines.

Also, do not drink alcohol and take statins until you have talked about it with your doctor.

What else should I tell my doctor?

Talk to your doctor about your medical history before you start taking cholesterol-lowering medicines. The risks of taking the medicine need to be weighed against its benefits. Here are some things to consider if you and your doctor decide whether to take a cholesterol-lowering medicine.

  • You have a history of liver problems.
  • You have other medical problems such as diabetes, gout, or ulcers. Nicotinic acid can make these conditions worse.
  • You have a history of kidney disease or gall bladder disease (especially if you may be taking a fibric acid derivative).
  • You are thinking of becoming pregnant, or you are pregnant (especially if you may be taking a fibric acid derivative).
  • You are breastfeeding.