Cardiac Medications

Cholesterol and Lipid Lowering Drugs

These drugs are used to treat abnormally high levels of one or more types of fats such as cholesterol or triglycerides. These drugs are given to reduce the risk of atherosclerosis (hardening of the arteries) usually when dietary and other measures have not worked. In patients with coronary disease, cerebro-vascular disease (strokes or TIA’s), peripheral vascular disease, abdominal aortic aneurysm and diabetes, aggressive lowering of total cholesterol and LDL cholesterol (the “bad”) cholesterol have been shown to reduce the risk of heart attack and stroke by as much as 30-50%.

In general cholesterol lowering agents are started early in patients with CAD. Modern medications are very effective in lowering cholesterol with minimal side effects. When initiated in patients with CAD and other manifestations of atherosclerosis, they should be continued indefinitely.

Classes of Lipid Lowering Medications:
Fibric Acid Derivatives
Cholesterol Absorption Inhibitors
Cholesterol Binding Resins

These drugs differ with respect to mechanism of action and degree and type of lipid lowering. In general, cholesterol can only be lowered about 10-15% by diet alone and it is difficult to adhere to a diet consistently. All patients should adhere to a low cholesterol diet. In many cases additional lipid lowering with medication will be required. If required, these medications are best initiated early to attain maximum benefit as soon as possible. If diet alone is sufficient in the long term, the dose of lipid altering medication may be reduced or the medication discontinued entirely. Most often patients on lipid lowering medications for CAD will have to remain on these medications forever. This will ensure that the coronary disease will progress as little as possible and may even regress (get better).

The choice of agent depends on the lipid abnormality:

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