Cholesterol Medicine Even Worth It?

Is Treatment With Cholesterol Drugs Worth It?

For many people, lifestyle changes just aren't enough to make a significant difference.

By Diana Rodriguez

Medically reviewed by Pat F. Bass III, MD, MPH

High cholesterol is often part of a package of health problems, perhaps with high blood pressure, heart disease, or even diabetes.

Many medications can be required to keep these conditions under control, and pretty soon your medicine cabinet can be overflowing with pill bottles while your wallet thins out from paying for all of those drugs. Even if high cholesterol medications are the only things you have to take, is it really worth the effort and expense?

Cholesterol Treatment: The Benefits of Statins

Statins are one of the most important cholesterol treatmentadvancements when it comes to extending and saving lives related to heart disease. "It used to be, 20 years ago, that once you had known heart disease you had a 10-year life expectancy; nowadays it's a normal life expectancy," says Stanley L. Hazen, MD, PhD, director for the Center for the Cardiovascular Diagnostics and Prevention at the Cleveland Clinic.

Heart disease is the number one killer of women and men in the United States, but regular use of statins saves many lives, says Dr. Hazen.

Cholesterol Treatment: Cost and Side Effects

The good news about statins and other cholesterol treatment options is that they're available in many forms, including many inexpensive generics. The cost can be very minimal, and the benefit of taking them is great.

While some side effects, most commonly muscle pain and stiffness, do occur, they're very common and can often be managed with some simple adjustments to the dosage, according to Hazen.

Cholesterol Treatment: What About Lifestyle?

People who may be able to manage cholesterol through diet andexercise alone are people who:

• Have only slightly elevated LDL ("bad" cholesterol)
• Have only slightly low HDL ("good" cholesterol)
• Don't have any other risk factors for heart disease
• Have cholesterol problems related to an unhealthy diet or sedentary lifestyle

People who probably need medication along with diet and exercise to treat high cholesterol are people who:

• Have moderately to very elevated LDL
• Have very low HDL
• Have other risk factors for heart disease
• Have high cholesterol because of genetic predispositions or who naturally produce too much cholesterol
• Have tried to lower cholesterol with diet and exercise unsuccessfully

"It used to be we would first try lifestyle changes like diet and exercise, then do medication," says Hazen. Now, the first line of defense is medications, along with lifestyle changes like diet and exercise, for people who meet certain criteria. Anyone with high levels of LDL — maybe 160 mg/dL (milligrams per deciliter) when the goal is 100 mg/dL or lower — definitely needs treatment with medication, according to Hazen. Such substantial decreases just can't be attained by diet and exercise alone.

People with significantly above normal LDL cholesterol levels and below normal (less than 40 mg/dL) HDL cholesterol levels should probably start taking a cholesterol drug to start controlling high cholesterol, particularly if they have other risk factors for heart disease like diabetes, high blood pressure, and are overweight.

But people who have moderately high cholesterol levels due to diet without any other risk factors for heart disease might start out trying to lower cholesterol with diet and exercise. It's important to stick with a healthy lifestyle and follow up with your doctor soon to make sure it's working and your high cholesterol is getting back to normal. Hazen notes that part of the problem with using lifestyle as a cholesterol treatment option is that many patients don't follow up and monitor their cholesterol levels, and don't stick with those healthy lifestyle changes.

Cholesterol Treatment: The Bottom Line

Statins are a proven method of protecting hearts and saving lives, and they require minimal cost and effort. Only your doctor can properly evaluate your risk and recommend a treatment plan. But if your cholesterol is high, medication may be the best way for you to protect your health and your heart. Whether or not you end up needing medication, everyone can benefit from sticking to a heart-healthy diet and getting regular exercise.