Alternatives to the use of statins as the standard therapy for lowering unhealthy LDL cholesterol are being devised. These alternative therapies include other medications to lower cholesterol, a heart-healthy diet, and even intestinal bypass surgery. According to the findings, when cholesterol levels decrease, these alternatives provide equal level of heart health protection as statins do.
A national survey shows the aggressive use of statins for lowering the production of cholesterol by the liver. According to the statistics, during 2011-2012, more than one-quarter of US adults aged 40 and above took statins.
To see the effectiveness of other cholesterol-lowering therapies, 49 clinical trials were undertaken which comprised of 25 clinical trials for statins. The trials for the other alternatives included a heart-healthy diet, which increasers fiber, a dietary component to help clear cholesterol from the bloodstream, and mediations like bile acid sequestrants, that helps the liver in drawing cholesterol from the bloodstream to further convert it into bile acids, and Zetia
(ezetimibe),which prevents the digestive tract from absorbing cholesterol.
Ileal bypass surgery was also tested, which also helps in converting cholesterol into bile acids after the length of the small intestine is shortened by bypassing its final section.
Two trials with PCSK9 inhibitors were also included in the review. These inhibitors are powerful cholesterol-lowering agents which also help the liver in clearing cholesterol from the bloodstream.
Through the study, different levels of effectiveness were recorded by these treatments. While statins helped in reducing cholesterol by 30%-50% depending on the dose, Zetia reduced it by around 20% and PCSK9 inhibitors by about 60%.
Dr. Nieca Goldberg, medical director of NYU Langone Medical Center's Tisch Center for Women's Health in New York City said, the review "supports that there are several options to lower LDL cholesterol and they all lower risk for cardiovascular disease". She adds that in addition to the medications prescribed, exercise and diet should always be part of the plan.