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The best way of avoiding the chronic complications of high cholesterol, that is, those resulting from atherosclerosis, is to maintain it under control. Therefore, each patient should be aware of their ideal cholesterol levels based on their age, risk factors and other diseases, and initiate measures (pharmacological and non-pharmacological) to control said levels.
In many cases it is advisable to start drug treatment. The drugs used to reduce cholesterol are safe medicines and only a minority of patients experience any side effects.
If you notice any side effects associated with your cholesterol medication, you must discuss them with your health professional, so they may perform an appropriate evaluation. You must not stop taking it of your own accord, as this could be dangerous, especially if you have previously suffered a heart attack or stroke.
Some specific advice to mitigate or recognise the side effects that could appear when taking statins, one of the drugs most commonly prescribed for high cholesterol, are:
Muscle aches. These usually develop in the legs or shoulders and on rare occasions there is isolated pain in the hands or feet. This complaint generally occurs with the highest doses and in people taking medications for other diseases. Do not drink large amounts of grapefruit juice if you are taking statins because it can provoke this side effect. In most cases the aches can be resolved by reducing the dose of the statin or by changing it for another type of statin, which must be assessed with the health professional.
Liver disorders. Statins can induce a slight increase in liver transaminase levels. However, patients should be aware that these blood test parameters may already be high if they have fatty liver disease, because of another medicine or disease, or if they drink too much alcohol, without having any relationship with the statins.
High blood sugar level. This tends to occur in patients who already have a slightly elevated blood sugar level (known as “prediabetes”) or in those with obesity and at higher statin doses. In any case, statins only produce a small increase, and this never contraindicates their use in patients with diabetes, in fact quite the contrary.
Finally, to avoid the cardiovascular problems associated with high cholesterol levels, three points must be taken into account:
Healthy lifestyle habits. It is recommended that they are assimilated and followed by all family members and also implemented at school, as the two strategies are the only way children will incorporate healthy habits into their daily lives and continue them into adulthood.
Establish synergies. It is essential for patients and the healthcare team (primary care, hospitals and health professionals) to work together in a coordinated and consensual manner.
Treatment adherence. After establishing the treatment goals with the medical professional, it is particularly important to follow the treatment in order to reduce the risk of developing a cardiovascular problem.
Excess body fat around the abdomen (belly) is associated with several diseases such as hypercholesterolaemia and high triglyceride levels. Weight loss, achieved in a safe and sustained manner, is linked to an improvement in these conditions.
Tobacco. Smoking increases the risk of chronic diseases (cardiovascular and respiratory diseases and cancer) and decreases life expectancy. Stopping smoking reduces cardiovascular risk via multiple mechanisms, one of them by increasing “good” or HDL cholesterol levels.
Alcohol. A high level of alcohol consumption is a risk factor for several cardiovascular diseases as well as other conditions. It is also associated with higher triglyceride levels.
Diet. The Mediterranean diet is one of the most popular dietary approaches to high cholesterol and triglyceride levels. It is characterised by being well-balanced, containing high-quality fats (mainly from olive oil, nuts and fish), a lot of fruits, vegetables and pulses (a source of fibre), and a low amount of refined sugars and saturated fats.
Exercise. Individualised physical activity provides multiple health benefits; it:
Improves cardiorespiratory fitness.
Helps control weight, decreases total cholesterol and triglycerides and increases the proportion of “good” (HDL) cholesterol.
Improves joint flexibility and mobility.
Increases muscle strength.
Improves mental wellbeing. Reduces anxiety and stress.
Sleep. Getting enough sleep helps increase everyone’s quality of life. It is important to get enough sleep (at least 7–8 h/day) and rest in order to cope with everyday activities. However, sleep in itself is not considered to have a significant influence on cholesterol levels.
Sexuality. An increase in cholesterol and other risk factors prompts the onset of atherosclerosis and can reduce blood flow to the genital organs. This can result in erection problems. Erectile dysfunction is sometimes an early sign of arteriosclerosis.
Travel. People tend to eat differently when travelling. Remember that there are always different options available – healthy and less healthy meals or foods. Before travelling, check you have enough medication to cover the duration of the trip, pack it in your hand luggage rather than in the hold to avoid losing it.
Emotional support. It is essential that the treatment team guides and offers support to the patient throughout the diagnosis and treatment of cholesterol problems, when implementing healthy habits and ensuring treatment adherence. This approach compels the patient to participate actively in the management of their disease. It is advisable to transfer this information to the family and people immediately around the patient in order to promote good health, in general, and control over their condition.