The American Heart Association (AHA) (2000) reports that the total blood cholesterol is usually the method of measurement indicating blood cholesterol (milligrams per deciliter of blood, mg/dl). However, absolute numbers for total blood cholesterol and HDL cholesterol levels are more useful for determining appropriate treatment (American Heart Association [AHA], 2000).
AHA also reports on drugs commonly used for treatment of hypercholesterol. First choice of drugs are bile acid sequestrants, cholestyramine, colestipol, and nicotinic acid (niacin). All have been shown to be effective in clinical trials and nicotinic acid is preferable in those with elevated triglyceride levels over 250 mg/dl, since this class of drugs will raise these levels. HMG CoA reductase inhibitors, lovastatin, pravastatin, simvastatin, and fluvastatin are statin drugs that are also considered effective for lowering cholesterol levels; these have only few and immediate short-term side effects. Gemfibrozil, probucol, and clofibrate are used as well, however, only probucol has received FDA approval (AHA; Cobos, Jovell, Garcia-Altes, Garcia-Closas, & Serra-Majem, 1999, p. 1924).
Cholestyramine and colestipol are used to lower cholesterol levels in the blood. They are not absorbed by the body and work by attaching to intestinal substances which are then passed out of the body unabsorbed. Consideration of other medical concerns such as allergies or pregnancy or diseases may prohibit the use of these drugs. Side effects of cholestyramine include the following: tumors (found in animals only); black stools, weight loss, stomach pain, nausea, and vomiting, (rare); and constipation, indigestion (common). Side effects of colestipol include: black stools, weight loss, stomach pain, nausea, and vomiting, (rare); and constipation, indigestion (common) (Micromedex, 2000).
Niacin lowers cholesterol and fat levels in the blood. The usual precautions taken f...