Initial treatment regimes for Hyperlipidaemia will depend on the degree of disease and also the level of cardiovascular risk (CVD) as determined by a patient’s doctor. Depending on the cause of Hyperlipidaemia (Familial or Secondary) it is possible that there will be several changes required to control the patients’ level of cholesterol.
Lifestyle factors should be considered for all patients. These include the modification of:
Depending on the patients’ response to lifestyle factors, many patients may also require medication therapy to lower their total cholesterol to satisfactory levels. As the total cholesterol is one important factor in managing CVD risk, it is important to understand that the presence of other risk factors, such as high blood pressure as an example, may also require medical management. The following discusses known lipid-lowering medications that are available.
There are several lipid-lowering medications available, they are known as:
Statins – a class of medications that may help lower low-density lipoprotein cholesterol (LDL-C). It achieves this by decreasing the production of LDL-C in the liver, which forces the body to seek this cholesterol from other sources in the body. Within the liver, statins inhibit some enzymes or proteins that alter the speed for LDL-C production.2
Bile Acid Sequestrants – contains compounds that prevent the reabsorption of bile in the intestine and increase the excretion of bile through faeces. This makes the liver produce more bile, which utilises cholesterol for this process thereby lowering the cholesterol levels in the blood.3
Fibrinic Acids – aim to lower triglycerides and raise good cholesterol (HDL-C). Fibrinic acids can increase the removal of triglycerides from the blood.4
Ezetimibe – a newer class of drug that lowers cholesterol by reducing the absorption of cholesterol in the small intestine, which reduces the amount of cholesterol delivered to the liver. This action may decrease the amount of cholesterol stored in the liver and increase the clearance of cholesterol in the blood.5