What can I do to treat a high cholesterol level in my blood?

More than 16 million women in the United States have what is considered to be high cholesterol. Standard recommendations suggest that it is optimal to keep LDL cholesterol below 100 mg/dL, HDL cholesterol above 50, and triglycerides below 150. Dietary changes may help prevent or manage high cholesterol. Drug treatment to lower the cholesterol level has not been proven to reduce the risk of developing heart disease for women who do not have heart disease or diabetes.

For women who have heart disease or diabetes, the group of cholesterol-lowering drugs known as statins can prevent heart attack and stroke. The statins available in the United States include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor). Statins reduce LDL up to 60 percent. They also raise HDL ("good" cholesterol) a few percent and lower triglycerides. The adverse effects of statins include muscle aches or weakness, liver problems, constipation, gas, indigestion, and stomach pain.

HDL is also raised by exercise, red wine, and niacin (vitamin B3). The doses of niacin needed to raise HDL are high enough to require medical supervision and monitoring of blood tests for safety. Large doses of niacin can also lower triglycerides. Triglycerides are a type of blood fat that confers the risk of heart disease. Triglycerides can be lowered by weight loss and eating a diet low in simple sugars. The best drugs for lowering triglycerides are fibrates, two of which are available in the United States, gemfibrozil (Lopid) and fenofibrate (Tricor). However, while these drugs reduce triglycerides, they do not reduce the death rate.