Diagnosis and Treatment
Adults should have cholesterol and triglyceride blood tests at least every five years. Traditional cholesterol tests are done in a laboratory and can measure individual lipid levels. The group of blood tests is known as a lipoprotein profile.

Home tests and public location tests are also available. These tests generally measure total cholesterol only, without separating results into good and bad lipids.

Proton nuclear magnetic resonance (NMR) spectroscopy may be the future of cholesterol testing. This test can detect radio signals sent by LDL and HDL particles, and may be the most accurate predictor of cholesterol and heart disease available.

Drug therapy is available to improve cholesterol levels by complementing healthy lifestyle changes if those changes fail to reduce cholesterol levels sufficiently. People with LDL levels greater than 190 mg/dl are most likely to receive medication from their physicians. However, people with family histories of heart disease will be given medication if their LDL levels are lower.

Statins, resins, and probucol are three types of drugs that aim to lower LDL levels. Fibrates and niacin target LDL as well as lower triglycerides and increase HDL. If you need to severely lower your cholesterol, your doctor may recommend a combination of drugs.

• Statins are especially effective in lowering LDL levels. They raise HDL levels as well, but not to as great a degree as other drugs. Statins are taken once or twice a day, depending on the type prescribed. Side effects may include stomach discomfort, muscle aches, drowsiness, and nausea.
  
• Niacin, or vitamin B3, reduces triglyceride levels and raises HDL better than any other anti-cholesterol drug. Incidentally, it is also the least expensive cholesterol-lowering drug. Its side effects are usually more intolerable than those of other drugs. Side effects include flushing in the face and neck, headache, and dizziness. The longer you take the drugs, the more tolerant you become to the side effects.
  
• Resins work by binding bile, a substance made by the liver. They decrease LDL levels with no great risk. Generally, they are used in powder form, but are also available as chewable bars. Side effects include gas, heartburn, and constipation. Vitamin supplements may be necessary if you take resins for an extended period because they deprive the body of vitamins A, D, E, and K.
  
• Fibrates effectively lower triglyceride levels and increase HDL for people who cannot tolerate the side effects of niacin.
  
• Probucol can lower LDL levels by 10 to 15 percent. On the other hand, it also lowers HDL levels 20 to 30 percent. People with genetic disorders that cause high cholesterol typically use probucol. Side effects include bloating, diarrhea, and nausea.
  

Last updated: 11-Feb-08