Should people be taking medicines to lower cholesterol?

Cholesterol has earned itself a bad name, considering it's association with many cardiovascular ailments. However, it is not the substance itself that is bad, rather high levels of it that increases your risk of heart diseases. That said, cholesterol is necessary to build healthy cells, make hormones, vitamin D, and digestive fluids. Only a high level of cholesterol is what is unhealthy.

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Most of the cholesterol in your body is made by your liver, whereas the rest is generated from the foods you eat. Given that the waxy, fatlike substance is insoluble in water, it travels in your blood through a particle called lipoprotein.

It is important to note that there are two types of cholesterol i.e. Low-density lipoprotein (LDL), which is bad, unhealthy cholesterol, and High-density lipoprotein (HDL), which is good. That said, it is likely that a high LDL cholesterol can damage your arteries and contribute to heart disease, increasing your risk for a stroke.

According to Dr. Shashidar, Director- Interventional cardiology, Fortis Hospital, Bannerghatta Road, Bangalore, "The deposition of cholesterol in blood vessels could be in the heart, brain, legs, abdomen. When it exceeds a certain level, it can reduce blood supply to a particular organ, especially the heart, and lead to many problems, like a heart attack. If in the brain, it can cause a stroke. In the leg, it can cause gangrene."

There are no definite symptoms that can tell you whether or not you have high cholesterol levels in your body. A blood test is the only way you can detect the same.

Read more: High cholesterol: Signs of dangerously high cholesterol levels present in your legs

The Centre for Disease Control and Prevention states that cholesterol testing should be conducted "every 5 years for people aged 20 or older who are at low risk for cardiovascular disease." Whereas those with cardiovascular disease risk factors must get themselves tested more frequently.

While there are no specific signs, one can watch out for the risk factors listed below.

- A family history of heart disease or high blood cholesterol.

- Older age

- Gender - Men tend to have higher LDL and lower HDL cholesterol levels than women do.

- Obesity

- Previous diagnosis with high cholesterol levels

- Unhealthy lifestyle habits like drinking and smoking

For people, who have been diagnosed with high cholesterol levels, doctors may prescribe certain drugs and medications. According to Dr. Brunda MS, Consultant - Internal Medicine, Aster CMI Hospital, "Statins, Fibrates, Bile acid sequesters and Nicotinic acid are some of the common drugs prescribed to lower cholesterol in patients."

While many medications are available to lower cholesterol levels, many factors determine whether a person requires them or not. It is important that the patient consults with a doctor about the same.

"The first line of treatment is making a change in diet and exercise. If the diet and exercise are not showing any improvements, we prescribe medicines based on the cholesterol levels and the patient's medical history and comorbidities," says Dr. Brunda.

According to Dr. Shashidar, "If LDL cholesterol is more than 190 ml dl, the person has to take the medication in consultation with the doctor." "He cannot get some over-the-counter medications because the medication dosage required needs to be decided by the doctor," he adds.

In order to determine whether a person needs medicines to lower cholesterol levels depends not only on the LDL levels, but also on other risk factors including diabetes and a high risk for cardiovascular disease.

A doctor usually calculates your heart disease risk score, which when greater than 5 percent can lead to the need for medications.

Dr. Shashidar says, "We have observed that the side effects can be attributed to minor side effects like body pain, muscle pain, & back pain. No serious adverse events are reported. They are safe drugs, and as long as the medical expert prescribes and the patient is on a regular follow up there is no need to worry about the side effects of the drug."

Similarly, Dr. Brunda elaborates by saying that the incidence of developing side effects is around 1 in 1,00,000 cases. "Side effects are very rare and it depends on the patient," she says. She adds, "Nausea, headache, muscle pain, liver defects are some of the side effects."

Futhermore, she suggests seeking medical help after 2 or 3 weeks if any side effects continue. Based on the cholesterol level and patient's medical background, doctors can also change the medications.

Depending on the patients' cholesterol levels, his or her medical history, doctors decide on whether or not they should be prescribed medicines.

"The proper medication depends on so many factors," says Dr. Shashidar.

It depends on whether the patient is hypertensive, has a family history, how high or low are his or her cholesterol levels.

"Sometimes a combination of medications is prescribed and just not one medicine. If a patient has a fatty liver, the dosage might be reduced, or the follow-ups might be increased."

"There are no contraindications concerning risk factors in particular or age groups with prescribing medications to lower cholesterol. It can be named to any age group. The dosage will be decided on factors like liver functions, CT functions on which remedy is best suited for the individual, " the doctor adds.