Experimental Drug Boosts Good Cholesterol, Lowers Bad
An experimental drug appears to safely boost good cholesterol, or HDL, to record highs, while dropping bad cholesterol to impressive lows. In a trial of nearly 2,000 patients who were already taking cholesterol-lowering statins, Merck and Co.'s anacetrapib increased HDL levels by 138 percent after 24 weeks, and lowered LDL levels by 40 percent, according to research presented today at an American Heart Association meeting in Chicago. Patients participating in the 18-month study all had or were at high risk for heart disease. "The lipid effects are jaw dropping in both directions," study author Christopher Cannon told Reuters. Patients who took anacetrapib suffered no side effects, and no safety concerns developed. More testing will determine if the drug's effects on cholesterol can translate into fewer heart attacks, and strokes the researchers said. "We are the most excited we have been in decades," Cannon told the Associated Press. "This could really be the next big thing."
It's much easier to push LDL down than to bump up HDL, but it's well worth the effort to strive to do both. U.S. News suggests 10 ways to improve your cholesterol:
1. Taking a statin can lower LDL by 10 percent (at the lowest dose) to 55 percent (at the highest dose), says Robert H. Eckel, professor of medicine at the University of Colorado-Denver and past president of the American Heart Association. A small percentage of people who take statins experience severe myopathy, which is muscle discomfort or weakness. (Consider 7 reasons statin users shouldn't dismiss muscle pain.) Statins also bump up HDL, typically by 5 to 10 percent (that's only 2 to 4 mg/dL, not enough to make much of a difference). Other types of cholesterol-lowering medications are sometimes prescribed in combination with statins.
2. A cholesterol absorption inhibitor would be a likely next step for those who can't take statins because of side effects, Eckel says. There is only one such drug—ezetimibe (Zetia). A 2003 study in the journal Pharmacotherapy found that when given alone or in combination with other cholesterol-lowering medications, ezetimibe reduced LDL by 15 to 20 percent and raised HDL, but, as with a statin, not by much—2.5 to 5 percent.
3. Bile acid sequestrants can decrease LDL by about 10 to 20 percent, according to the National Heart, Lung, and Blood Institute. When combined with a statin, these medications can lower LDL by more than 40 percent. Medications in this class—cholestyramine, colestipol, and colesevelam—come in pill or powder form. The powder must be mixed with water or juice before being taken. These drugs offer an added benefit for diabetics: Research has shown they help to lower blood glucose levels.
4. Nicotinic acid, also known as niacin, is a water-soluble B vitamin that lowers LDL by 10 to 20 percent and is the only drug that can have a real impact on HDL, says Eckel. According to the NHLBI, it can lift HDL levels by 15 to 35 percent. A study published in 2009 in Current Medical Research and Opinion says that niacin and fibrates (explained below) are underutilized—either alone or in combination with statins—to treat low HDL and high triglycerides (a kind of fat in the blood). Because most people who take niacin experience flushing of the skin and a warm feeling, particularly on the face, neck, and ears, up to half of those taking the medication choose to stop it, according to the Mayo Clinic.
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