More than 100 million Americans have high cholesterol (above 200 mg/dL), which can clog arteries and cause heart attacks and strokes.
Statins
Pros: Statins include drugs such as Lipitor, Zocor, and Crestor (all the generic names end in statin), and they can lower LDL, or “bad,” cholesterol by more than 50%. "Across the board, they are clearly a wonder drug," says Thomas Pearson, MD, PhD, the Albert D. Kaiser professor of preventive medicine at the University of Rochester Medical Center, in Rochester, N.Y.
Niacin
Pros: Niacin is a B vitamin that lowers both LDL cholesterol and triglycerides, fats that can be harmful at high levels. It also raises HDL, or "good," cholesterol. "It's a powerful drug," Dr. Pearson says. It comes in tablets to be taken two or three times a day, or in an extended-release formula, which needs to be taken only once a day.
Dietary fiber
Pros: Dietary fiber—found in beans, fruits, and other foods—binds to cholesterol, lowering LDL levels by about 5%, Dr. Pearson says. "It fills you up and often doesn't have a lot of empty calories in it," he adds. "It could be called a modest addition to the therapeutic regimen." It's also cheap and easy, available at grocery stores.
Red yeast rice
Pros: This dietary supplement is derived from a fungus that grows in rice and contains small amounts of lovastatin (Mevacor). It can be effective in people who can't take statins, says Jacob Warman, MD, chief of endocrinology at the Brooklyn Hospital Center, in New York City. Although different people see different benefits, he says, "it always works to some extent."
Bile acid sequestrants
Pros: Drugs such as Questran (cholestyramine), Welchol (colesevelam), and Colestid (colestipol) trick the body into producing extra bile, which lowers LDL cholesterol by about 15% to 20%, Dr. Pearson says.
Low-fat diet
Pros: Choosing healthy food such as fish and veggies over red meat and french fries is relatively straightforward, and Dr. Warman estimates it could lower cholesterol by up to 20% in some people. Societies with low-fat diets, such as Japan and parts of the Caribbean, have lower levels of heart attack and stroke.
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