REPORT #1396
BACKGROUND: They've been touted as wonder drugs. Some doctors even joke statins should be added to the water supply. These prescription medications can lower LDL, or "bad" cholesterol levels by 25 to 50 percent. But for patients who don't tolerate them well, or who are looking for cheaper alternatives, what else is there? Here's the scoop on some other things that improve cholesterol, although it's important for patients to note these won't give the dramatic improvement in cholesterol like statins will.
NIACIN: It's a B vitamin that boosts HDL cholesterol -- the "good" cholesterol -- by up to 35 percent, with the potential to protect people against heart attacks and stroke. It can also reduce LDL levels by as much as 20 percent. Although it's inexpensive compared to statins, its use has been limited because of side effects like uncomfortable skin flushing, blood sugar increases, stomach irritation and gout.
CHINESE RED YEAST RICE: This supplement is actually a naturally occurring statin with the same chemical structure as the prescription medication lovastatin (Mevacor). But according to Linda Hemphill, M.D., a cardiologist with Massachusetts General Hospital in Boston, some patients tolerate this better than prescription statins. It can lower LDL levels by up to 20 percent.
ZETIA: Zetia, generic name ezetimibe, is a cholesterol absorption inhibitor. According to Dr. Hemphill, "Some patients may be able to take a low-dose statin in combination with this to get a more dramatic LDL reduction without side effects."
FIBRIC ACID DERIVIATIVES: These prescription medications are very effective at lowering triglycerides and modestly raising HDL levels.
BILE ACID BINDERS: One of the oldest medications for lowering cholesterol, these bind to bioacids. You can get a 15- to 18-percent reduction in LDL levels with mild side effects.
FOODS:
• Pistachios: A handful of these may lower cholesterol and provide the antioxidants found in leafy green vegetables and brightly colored fruit. Researchers from Penn State reported that, "Pistachio amounts of 1.5 ounces and 3 ounces -- one to two handfuls -- reduced risk for cardiovascular disease by significantly reducing LDL cholesterol levels, and the higher dose significantly reduced lipoprotein ratios," at the Experimental Biology meeting in Washington, D.C., on April 30, 2007
• Garlic: Garlic has a modest effect on lowering LDL, total cholesterol and triglycerides
• Portfolio Diet: Includes foods like almonds, beans, fruits, vegetables and whole grains. It replaces meat with whole grains and focuses on fiber. Patients who followed it saw a 30-percent reduction in LDL
• Citrus: In animals, compounds in orange and tangerine peels lowered cholesterol and triglyceride levels by about 40 percent
• Other foods: Walnuts, soy milk, red wine and chocolate
For More Information, Contact:
Linda Hemphill, M.D.
Massachusetts General Hospital
Boston Heart Associates
(617) 726-4150
