LDL cholesterol level determines heart disease risks. What foods can lower cholesterol? Can supplements lower LDL cholesterol? Diet and lifestyle change lower cholesterol by 5% at best. Only statins can lower cholesterol by 20-50%.

Best ways to lower cholesterol fast. Dr. Anton Titov, MD. When to use only lifestyle changes to lower cholesterol? Video interview with top expert in cardiology. How low should cholesterol be? When to use medications (statins) to lower blood lipids? Dietary changes to lower blood lipids and cholesterol. Interview with Dr. Dale Adler, MD. How to lower blood lipids naturally? Second opinion ensures that high cholesterol hyperlipidemia diagnosis is correct and complete. Second opinion also helps to choose the best treatment strategy for hyperlipidemia or hypertriglyceridemia. Seek second opinion on familial hyperlipidemia. Be confident that your treatment is the best. Best ways to lower cholesterol fast. Medical Second Opinion. Dr. Anton Titov, MD. How to lower cholesterol? Let's discuss treatment of high cholesterol. High cholesterol level is a major risk factor for coronary heart disease. Recently the clinical guidelines for use of statins have changed. Statins are major drugs to lower cholesterol. Revision of statin use guidelines generated controversy in medical community. Under the new guidelines a number of patients who should use statins to lower cholesterol have increased. But many patients do not make full use of non-pharmacologic methods for lower cholesterol. It is the lifestyle changes, better food, and dietary changes. Dr. Anton Titov, MD. How do you approach reduction of risk factors for coronary heart disease in your practice? Second Opinion (Cardiologist, Professor of Medicine, Harvard Medical School). Dr. Dale Adler, MD. Since early 1980s we have learned that LDL cholesterol is the bad cholesterol Any lifestyle modifications and any medications that specifically lower the level of LDL cholesterol. It is almost always there is a benefit to the patient. It seems that the lower you make LDL cholesterol level. The lower the risk of coronary artery disease. Can LDL cholesterol be too low? Sometimes LDL cholesterol is too low. Can this create a problem? Dr. Dale Adler, MD. This has been a controversial issue. Probably too low level of LDL cholesterol is not really a problem for most patients. We are not so worried that LDL cholesterol is going to be too low. Some patients who do not have very high risks for coronary heart disease. We would love to see them work on improving their lifestyle. No question about that. Who has low risk profile for coronary heart disease? #1: Those patients who do not have a family history of very premature coronary artery disease. #2: Those who do not have diabetes. #3: Those who never had any heart-related health event whatsoever. But lifestyle change is a tough proposition. Relatively few patients can keep their weight just where it should be. Few patients can exercise on a regular basis. Few patients have very good diet. Let's now look at patients who have already had a heart-related health problem (heart attack). Some patients have diabetes. Some patients have a strong family history of premature coronary artery disease. In my clinical practice I support healthy diet and lifestyle changes. This is all terrific. But diet and lifestyle lowers LDL cholesterol in these patients by only 5%. Medications, the statins, often lower cholesterol by 20% to 40%. Medications and lifestyle / dietary changes are synergistic. So it's wonderful to put them together. So I say to my patients. "Let's make your LDL cholesterol very low. Let's drive it down." Dr. Anton Titov, MD. The recent clinical guidelines on the use of statins to lower cholesterol are controversial in several areas. One controversy is about the dose of statins to treat patients. Also there is controversy about evidence on how much coronary heart disease risk is lowered. Medical Second Opinion. Dr. Dale Adler, MD. I agree very much with the guidelines when they say this. Sometimes you're going to use the statin to lower cholesterol. Then use statin in a dose that was used in the clinical trial. For example, simvastatin is a very nice medication to lower cholesterol. In the clinical trials simvastatin was used at 40 milligrams per day. But a lot of physicians prescribe simvastatin at 5 milligrams or 10 milligrams per day. I say this. Sometimes it's worth treating a patient with a statin medication. Then start medication in a dose that was established and shown to make a big difference. Sometimes the patient has trouble tolerating statin at that dose. Dr. Dale Adler, MD. Then you may have to decrease the dose of medication. That even occurred in some of the clinical trials. Best ways to lower cholesterol. Dr. Anton Titov, MD. Who can only use lifestyle and diet changes? When to add medications to help lower cholesterol? How to use statins correctly?