Keys to Controlling Cholesterol

WHO defines cholesterol as a natural fatty substance present in all cells of the human body, essential for the normal functioning of the body. Cholesterol is a fat (lipid) that is formed in the liver from fatty foods.

1. What treatments are used to control cholesterol levels?

The need for treatment to lower cholesterol levels must be individualized for each person and largely depends on the risk of cardiovascular events (heart attack or stroke). Treatment and prevention of hypercholesterolemia usually involves lifestyle changes and, in some cases, also requires the use of medications.

2. What lifestyle changes have a positive effect on cholesterol control?

Maintaining a healthy lifestyle, healthy eating and regular physical activity is associated with better control of blood cholesterol and triglyceride levels. Regular physical activity can help greatly: it is recommended to do at least 175 minutes of moderate-intensity exercise per week. Losing weight can also help lower cholesterol levels when a person is overweight or obese. Finally, it is important to quit smoking. Tobacco can lower good cholesterol (HDL) and increase LDL (bad cholesterol).

3. What kind of diet should you follow and what foods should you eat?

You should eat a healthy diet that limits your intake of foods high in saturated fats and trans fats, such as red meat, processed and fried foods; and increase your intake of healthy fats, including foods such as avocados, nuts, seeds and olive oil. The Mediterranean diet has been shown to have beneficial effects on cholesterol and triglyceride levels and reduce the risk of cardiovascular disease. You need to consume fiber-rich foods such as fruits, vegetables, legumes and whole grains.

4. What if we do all the steps mentioned above and still don’t get good cholesterol numbers?

In many cases, pharmacological treatment begins at this point. There are several pharmacological strategies to reduce it.

5. What treatment methods are the most famous?

Statins are the treatment of choice and are currently the most widely used. There are various compounds in this group, the most representative of which are simvastatin and atorvastatin. Ezetimibe reduces the absorption of cholesterol in the intestine. It is a very well-tolerated drug that helps reduce LDL cholesterol levels by 15-20%. Fibrates are primarily used to lower triglyceride levels, although they may have mild to modest cholesterol-lowering effects. Finally, resins are drugs that act at the intestinal level, so they promote the excretion of bile (very rich in cholesterol). For people with serious genetic cholesterol diseases and very high cholesterol levels, apheresis, a method similar to blood purification, is used. It is used in patients who do not achieve optimal control despite regular pharmacological treatment.

6. Is there a vaccine for cholesterol?

Well, not as such, since it’s not really a vaccine, but rather a vaccine-like treatment that is administered by injection rather than orally like other modern medications. The purpose of the new drug Inclisiran is to prevent liver cells from producing a protein that increases the level of bad cholesterol in the blood. It is a medicine that is given subcutaneously, like many other medicines, but that does not make it a vaccine.

7. And who is it addressed to?

Well, at the moment it is only funded for patients with primary hypercholesterolemia (familial and non-familial heterozygous) or mixed dyslipidemia.