Treatment of Hyperlipidaemia and lipid-lowering medicines

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The first steps in lowering LDL cholesterol and triglycerides are having a low fat diet, giving up smoking and increasing exercise levels. Cholesterol and triglycerides can be measured in a blood test. If these measures fail to lower lipids enough, medications are generally added.

You should continue your diet and exercise programs when taking medication as these improve the effects of the medications. Lipid- lowering medicines ideally lower the blood levels of low density lipoprotein (LDL), and raise those of high density lipoprotein (HDL) and lower levels of triglycerides.

Statins are a group of drugs used for lowering the levels of LDL cholesterol in the body. They work by blocking an enzyme (HMG coenzyme A reductase) that is involved in the production of LDL cholesterol, especially in the liver.

The main effect of statins is to reduce LDL cholesterol, but they may also reduce triglycerides to a small extent and increase high-density-lipoprotein HDL cholesterol. They are effective in lowering LDL cholesterol.

Fibrates The main effect of fibrates is to reduce triglyceride levels; they also increase HDL cholesterol but have little effect on LDL cholesterol. They are used mainly in people with raised triglyceride levels, often associated with low levels of HDL cholesterol.

Bile acid sequestrants combine with bile acids in the gastrointestinal tract to form compounds that are excreted in the faeces. This results in reduction of LDL cholesterol.

Nicotinates include nicotinic acid and its derivatives. It is a member of the vitamin B group and, in high doses it reduces triglycerides and increases HDL cholesterol, and may also slightly reduce LDL cholesterol. They are used mainly in people with raised triglyceride levels. They are mainly used when your hyperlipidaemia has not responded to other medicines.

Omega 3-6 essential fatty acids are a group of fatty acids found in oils, nuts and seeds as well as some fish such as sardines, mackerel, and herring. They are called essential because the body cannot make them; they must be obtained from food sources. They can also be taken in capsule- form The Omega 3-6 essential fatty acids lower triglycerides and, at high levels, may lower LDL cholesterol and increase HDL cholesterol. Active omega-3 compounds may be added to the diet.

Cholesterol Absorption Inhibitors such as ezetimibe are sometimes used in combination with a statin, or on their own. They work by decreasing the absorption of cholesterol from the small intestine.

Medicines for Hyperlipidaemia
If you are taking one of the medicines listed below for a different condition (i.e. not Hyperlipidaemia or your lipid- lowering medicine is not listed below, speak to your prescriber, GP or pharmacist or contact NHS Direct 0845 46 47