How to Choose Medications for High Cholesterol and Triglycerides

High blood lipids refer to conditions such as hypercholesterolemia and hypertriglyceridemia. Hypertriglyceridemia is often caused by excessive calorie intake, so dietary control is essential. If triglyceride levels remain high despite lifestyle changes, medication may be necessary. Among the available options, fibrates are considered the most effective for lowering triglycerides. Drugs like Lipanthyl (fenofibrate) offer strong triglyceride-lowering effects and are generally well tolerated by patients.

Alternative Options for Managing Triglycerides

Niacin, or vitamin B3, is another medication that can significantly reduce triglycerides while simultaneously increasing high-density lipoprotein (HDL), the "good" cholesterol. However, niacin can cause side effects such as facial flushing and gastrointestinal discomfort. Starting with a low dose and gradually increasing it can help monitor and manage these effects. If patients tolerate the lower dose well, the dosage can be increased for better results.

Potential Drawbacks of Other Treatments

Another class of medications, bile acid sequestrants, works by binding to bile acids in the intestine and promoting their excretion, especially after high-fat meals. While effective, these medications may cause digestive issues such as bloating and abdominal pain. Due to these side effects, fibrates and niacin are often preferred for managing elevated triglyceride levels.

Statins: The Gold Standard for Lowering Cholesterol

Statins are among the most widely prescribed medications for lipid management, especially in patients with cardiovascular conditions like coronary artery disease or cerebrovascular disease. These drugs are highly effective at lowering low-density lipoprotein (LDL) cholesterol—by up to 50% in some cases. Beyond their lipid-lowering properties, statins also have anti-inflammatory effects, help slow the progression of atherosclerosis, and improve endothelial function, making them a top choice for long-term heart health.

Complementary and Natural Approaches

In addition to conventional medications, certain herbal remedies have shown promise in managing lipid levels. Products like Xuezhikang (a red yeast rice extract) and Houdan tablets are commonly used in traditional Chinese medicine and have been found to lower cholesterol and triglycerides by approximately 20–30%. While they may not be as potent as prescription drugs, they can serve as a useful adjunct in a comprehensive lipid-lowering strategy.