Two main types of fats (lipids) are found in the blood, cholesterol and triglycerides (lipoproteins). Cholesterol is an essential component found in all human cell membranes. Triglycerides are necessary to help transfer energy from food into body cells.
High levels of low density lipoprotein (LDL) cholesterol are one of the causes of altered structure of the innermost layer of the artery's wall. Elevated LDL levels are associated with the formation of atherosclerotic plaque (fatty material that becomes hardened, blocking the artery and stopping blood flow).
Cholesterol levels may rise and fall based on the types of fat you eat, the amount of exercise you do, and your weight. Your physician may advise you to make changes in your diet as well as suggest an exercise and weight reduction plan specific to your needs. In some cases, there may be a family history of elevated fats in the blood. Your physician will advise the best treatment for your particular condition.
Lipid (fat) lowering therapy may be recommended to help reduce the progression of atherosclerotic disease. The National Cholesterol Education Program III (NCEP-III) guidelines recommend a target goal of LDL cholesterol at less than 130 mg/dl. However, if you have a higher risk for heart disease, an LDL of below 100 is ideal. The optimal goal for your LDL cholesterol can depend on other risk factors. Your health care provider will consider your individual risk factors to help determine what is best for you. Recommendations for other types of fats in the blood include triglycerides less that 150 mg/dl and high density lipoproteins (HDL) greater than 40 mg/dl.
Your physician may determine that you require a medication to maintain a specific cholesterol level in addition to dietary and exercise changes. There are several types of medications used to decrease cholesterol. Statins are a group of antihyperlipidemic medications, and include simvastatin (Zocor®), atorvastatin (Lipitor®), and pravastatin (Pravachol®), among others. Studies have shown that certain statins can decrease the thickness of the carotid artery wall, increase the size of the lumen (opening) of the artery and reduce vascular inflammation thought to be a cause of atherosclerosis.
Because atherosclerosis may progress to the point of narrowing or blocking blood vessels, another type of medication may be used to prevent narrowing or blockage caused by blood clots. Antiplatelet medications (platelets are blood cells that stick together to prevent bleeding) may be used to decrease the "stickiness" of platelets and help prevent blood clots from forming inside blood vessels. Such medications include aspirin, clopidogrel (Plavix®), or dipyridamole (Persantine®).