If you have had a heart attack (myocardial infarction in medical terms) once, you are exposed to the risk of another one occurrence. Therefore, you need to adhere to a healthy lifestyle and take special medicaments prescribed by a healthcare professional. These medicaments are designed for decreasing high cholesterol/triglyceride levels – great risk factors of repeat heart attack occurrence. Let’s consider this matter in detail.
How to Reduce the Cholesterol in the Body Naturally?
- Eat healthy food. WHO & American Heart Association give some advice on healthy diet that will help you to reduce cholesterol levels. Healthy diet should be based on whole-grain food, vegetables, fruits, nuts, beans, as well as fish and poultry without skin. Whole-grain food includes non-processed cereal products, such as brown rice, bulgur and whole-grain oatmeal. It’s advised to choose unsaturated fats contained in nuts, avocados, and olive oil as replacements of saturated fats (red meat, cheese, etc.) Don’t consume trans fats that are contained in fast food (burgers, French fries, etc.), cakes, cookies, and margarines, as they provide bad impact on cholesterol levels. Eat a lot of fruit & vegetables.
- Quit smoking. This dangerous habit damages your arteries, which leads to the formation of fatty atheromas narrowing the artery (heart attack risk factor). In addition, it affects oxygen content in the blood and raises arterial pressure increasing heart load.
- Don’t abuse alcohol. Abundance of alcoholic beverages can lead to weight gaining and obesity resulting in enlarged arterial pressure and triglyceride levels. However, moderate dosages of beverages (1-2 drinks a day) will positively influence blood lipid profile.
- Avoid stress. Acute psychological stress can increase arterial pressure. It leads to the release of "unhealthy" hormones, such as cortisol and adrenaline. In addition, if you are under stress you can eat a lot or smoke cigarettes.
- Be active and control your weight. Try to do moderate cardio exercises at least 5 days a week for 30-60 minutes a day (after a consultation with a healthcare expert). Training will improve “good” cholesterol and allow you to control weight because obesity is one of significant risk factors of repeat myocardial infarction. Obesity enlarges triglycerides & cholesterol rates in the blood, increases arterial pressure and induces diabetes (another heart attack risk factor). Moreover, Scottish researchers have recently claimed that obesity itself may cause a heart attack, but the causal relationship between excess weight and infarction has not yet been determined.
Pharmaceutical Methods of Repeat Heart Attack Risk Lowering
The use of only natural ways of controlling cholesterol may not be enough for male and female persons who have already suffered a heart attack. Therefore, to reduce the risk of this dangerous disease, special medicaments have been developed. Some of them block the absorption of cholesterol, others reduce triglycerides in the blood and “bad” cholesterol and so on. Below you can learn more about these medical remedies and the mechanism of their action.
Meds Blocking Cholesterol Coming From Food
Cholesterol is an organic molecule belonging to the group of steroid alcohols. Our body is capable of producing the amount of cholesterol that it needs. However, this substance is also contained in some food products, especially in eggs, fatty meet, fatty dairy products, etc. Such medicaments as ezetimibe (Zetia) and phytosterols, inhibit absorption of cholesterol coming with food products.
Drugs for LDL Lowering
LDL (or “bad” cholesterol) is a type of blood lipoproteins. They are one of the key cholesterol transporters in the blood. When the level of these lipoproteins is very high, cholesterol starts to be deposited inside the arteries and other vessels causing fat deposits to be formed. Fat in the vessels is a cause of development of atherosclerosis, which can cause blockage of arteries, bad blood supply to the heart, and as a result, a heart attack. Medicaments belonging to statins group (simvastatin marketed as Zocor, rosuvastatin, atorvastatin etc.) lower LDL by approximately 18-55%.
The newest group of anti-LDL medicaments is represented by PCSK9 inhibitors including evolocumab (Repatha trade name) & alirocumab (Praluent) that were approved by the US FDA in 2015. They block PCSK9 substance allowing the body to remove excess LDL. However, these drugs haven’t been used for a long time and not all their possible undesirable effects are known.
Medications for Triglycerides Lowering
Triglycerides are fatty substances found in the blood. They are used for the production of energy in the body. Each person needs some quantity of triglycerides in his/her blood. But if their level is too high, cardiovascular events, such as infarction, may occur.
Fibrates, such as fenofibrate and gemfibrozil, can lower triglycerides up to 50% depending on a particular drug. Prescription niacin (also known as nicotinic acid) causes effect similar to that triggered by fibrates. Such drugs as orlistat (Xenical trade name) block absorption of fats (approximately by 30%) in the intestine by inhibiting lipase, an enzyme responsible for triglycerides’ digestion. Xenical is used in cases of obesity and for preventing heart attacks associated with excess weight.
Drugs for HDL Raising
Like LDL, HDL lipoproteins (“good” cholesterol) are carriers of cholesterol substance throughout the body. The distinguishing feature of HDL is its ability to transport cholesterol from different body parts to liver that excretes this substance. In addition, HDL is highly soluble and is not prone to precipitate cholesterol, thus protecting the vessels from atherosclerotic changes.
Now, there are no special medicaments for HDL raising. Clinical experiments on several drugs designed for this purpose were stopped at early stages, as the tested medical substances didn’t decrease the risk of myocardial infarction. HDL levels may be improved only by medicaments used to decrease LDL & triglyceride levels mentioned above.
Decreasing Total Cholesterol In the Body
Total cholesterol indicator represents the overall quantity of cholesterol & triglycerides. You may decrease total cholesterol with the help of the abovementioned medicines. They lead to a significant decrease in LDL, a relatively small increase in HDL, and reduction of triglycerides. All these effects result in total cholesterol decreasing.
Vytorin – a Modern Drug to Prevent Repeat Heart Attacks
Vytorin is an oral drug produced by Merck & Co. It contains two main agents providing complex effect. The first agent (ezetimibe) reduces the quantity of cholesterol absorbed in digestive tract. The second component (simvastatin) decreases cholesterol directly in the body by the suppression of the HMG CoA enzyme, which takes part in the initial stage of cholesterol synthesis. As a consequence, “bad” cholesterol as well as triglycerides decrease. At the same time, taking the medicament leads to slight increase in the levels of “good” cholesterol. Clinical experiments (Ballantyne CM, 2005) have shown that Vytorin as a complex drug is more effective than a statin drug (Lipitor) alone.
Cholesterol Medications Comparison
Below you’ll find the table comparing Vytorin with some competitor medicaments. The table is based on researches of Ballantyne CM (2005), Pedersen TR (2004), and Nutescu EA (2003).
|Price per pill||Link|
Ezetimibe + Simvastatin
From 10/10 mg per day to 10/40 mg per day
47%-59% LDL reduction, triglycerides reduction, HDL increasing
10mg per day
15%-20% LDL reduction, HDL increasing. Doesn’t affect triglyceride rates
5-40 mg per day (sometimes 80mg a day)
47% LDL reduction (on average), triglycerides reduction, HDL increasing
10-80 mg per day
36%-53% LDL reduction, triglycerides reduction, HDL increasing
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