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Lowering cholesterol: When lifestyle changes aren’t enough

You eat a balanced diet—not too much meat or dairy products—and you exercise regularly on the treadmill. You’ve even quit smoking—so why is your cholesterol still sky-high?

The answer lies in your genes as well as in your lifestyle choices. Which is often why even if you do everything right, you may need to take medicine to lower your cholesterol. Age and gender also play a factor. The older you are, the more your levels tend to rise. The risk is even greater for postmenopausal women.

Only two options

You can really lower your cholesterol in only two ways: lifestyle changes and drug treatment. So, if you’re truly doing all your doctor recommends, it might be time to look at your medical options.

First, you need to understand cholesterol. Cholesterol comes from two sources: your body and food. The cholesterol produced in your body naturally (mostly in the liver) is called blood cholesterol. The cholesterol found in the foods you eat is known as dietary cholesterol.

  • Blood cholesterol. The cholesterol produced in your body is a waxy, fatlike substance that’s needed to form cell membranes and other tissues. Your body already produces enough blood cholesterol on its own to perform this function.
  • Dietary cholesterol. Dietary cholesterol is found in meat, poultry, seafood and dairy products. According to the American Heart Association, your average daily intake of dietary cholesterol should be less than 300 milligrams. And what you consume greatly influences your cholesterol numbers. (Ideally, you want your levels to be less than 200 mg/dL.)

Because cholesterol and other fats can’t dissolve in the blood, they have to be transported by special carriers, or lipoproteins. Low-density lipoproteins (LDL) are the unhealthy, or bad, ones—the main sources of cholesterol buildup and blockage in the arteries.

When medicine is the answer

Your first line of defense against high cholesterol is to consume a low-fat, low-cholesterol diet, quit smoking, exercise regularly and get any medical conditions under control that will help keep your levels in check.

But if the combination of your family history, age and gender makes it difficult to reduce your cholesterol levels, your doctor may recommend medication in addition to a healthy lifestyle regimen.

The main goal of cholesterol-lowering treatment is to lower your LDL levels to reduce your risk of heart disease or heart attack. Taking medicine does not mean you can start smoking again or smear tons of butter on your morning toast. Medication must be combined with a healthy lifestyle.