High cholesterol is one of the biggest risk factors for heart disease and stroke. These are the leading causes of death around the world.
While eating a healthy diet and exercising regularly can help lower cholesterol, for many people, lifestyle changes aren’t enough.
That’s when medications come in. Most people have heard of statins, which are the most common drugs used to lower cholesterol, but many don’t know there are other options too.
A new national survey from The Ohio State University Wexner Medical Center asked over 1,000 adults about their knowledge of cholesterol medications and heart health. The results showed that while 60% of people had heard of statins, 61% didn’t know there were non-statin medicines available.
Less than half knew that statins are proven to lower cholesterol effectively. Most people also hadn’t heard of lipoprotein(a), an inherited kind of cholesterol that can’t be controlled with diet or regular medication. And 67% had never heard of a heart scan called the coronary artery calcium score, which helps detect early signs of heart disease.
Dr. Laxmi Mehta, a heart specialist at Ohio State Wexner Medical Center, says that even though statins sometimes get a bad reputation, the research is clear—they work well and help lower the risk of heart disease. However, for people who can’t take statins or need extra help lowering their LDL cholesterol, there are now other medicines available.
These non-statin drugs come in pill or injection form. They are helpful for people who can’t tolerate statins, have very high cholesterol, or have extra risk factors such as high levels of lipoprotein(a). Some people may even take a statin and a non-statin together to get the best results.
Some of the non-statin medications include:
Ezetimibe: A pill that helps block cholesterol from being absorbed in the intestines. It can lower LDL by 18–25%.
PCSK9 Inhibitors: Injections taken every two to four weeks that can cut LDL by 45–64%.
Inclisiran: An injection given twice a year that can reduce LDL by about 50%.
Bempedoic Acid: A pill that works well for people who can’t take statins, lowering LDL by 21–24%.
One type of cholesterol that’s been getting more attention lately is lipoprotein(a), or Lp(a). This kind of cholesterol is inherited, and around 1 in 5 people have high levels of it.
You can’t lower Lp(a) by eating better or exercising, and there’s no approved medicine yet, though new treatments are being studied. High Lp(a) levels can cause buildup in the arteries, inflammation, and increase the risk of blood clots.
Because Lp(a) runs in families, doctors recommend checking levels if a close relative had a heart attack or stroke before age 55 in men or 65 in women, especially if there are no other common risk factors. If someone has high Lp(a), their children have a 50% chance of having it too. These people should take medicine to lower LDL and reduce overall heart risk.
Another tool to watch for early heart disease is a coronary calcium scan. This quick test shows whether there is calcium buildup in the arteries. It’s useful for people aged 40 to 65 who may not have symptoms but have risks like high cholesterol, family history of heart problems, diabetes, or smoking.
Toni Gundling, a 69-year-old personal trainer, is one of Dr. Mehta’s patients. Despite her healthy habits, her family history of heart disease caught up with her. Her father had bypass surgeries in his 40s, and her younger brother also needed one.
Gundling tried to manage her cholesterol with diet and exercise, but it wasn’t enough. She eventually started a statin and later added a non-statin medication. While she experienced some side effects, working closely with her doctor helped her find the right treatment.
Gundling encourages others not to fear medication. “Not everyone can take the same pill,” she said. “You have to find what works for you.” She said that going on medication gave her peace of mind because it helped with something she couldn’t fix by herself.
This research shows the importance of education about cholesterol, inherited risks, and the range of treatment options. Knowing your numbers and having regular checkups can help prevent serious health problems down the road.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and herbal supplements could harm your heart rhythm.
For more health information, please see recent studies about how drinking milk affects risks of heart disease and cancer, and results showing strawberries could help prevent Alzheimer’s disease.
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