Patients who have high levels of “bad” cholesterol, or LDL cholesterol, who haven’t been able to lower it with lifestyle changes or statins may achieve their goal with an injectable drug.

This class of injectable drugs, known as PCSK9 inhibitors, has dramatically lowered stubborn LDL levels when used with a statin.

Statins are drugs that lower LDL levels, along with a healthy diet and exercise.

Having too much bad LDL cholesterol, or hypercholesterolemia, is bad for your heart. It leads to more fatty deposits in your arteries and makes it more likely that an artery will be blocked.

HDL, or good cholesterol, actually removes cholesterol from your blood.

The injectable drugs target a protein known as PCSK9, which, when genetically mutated, interferes with a statin’s work to clear out bad cholesterol. The injectable drug blocks PCSK9 so the bad cholesterol can be removed from the blood.

The best candidates for this injectable drug are patients who have the most difficult-to-treat LDL levels. Those with familial hypercholesterolemia (FH), for example, have a genetic condition that causes high cholesterol and can lead to heart disease at an early age. They don’t see results with the highest doses of statins and lifestyle changes.

The injectable drug also helps people with documented atherosclerosis who are unable to achieve their LDL-lowering goals with lifestyle changes, statins and Zetia® (a cholesterol-lowering drug), or those who are intolerant to these medications because of myalgia and side effects.

The PCSK9 inhibitors, which focus on the genetically mutated protein, are essential treatment for FH.

Before, you could have had bypass surgery and stents and an LDL over 200, and if you couldn’t tolerate statins or Zetia, you had no other options. This is a game changer. Because now we can do something.

The injectable drug is typically given once or twice a month. You may think, “Why would I take an injectable every two weeks?” When it’s amazingly effective and easy and, in some cases, your only hope, it’s a welcome addition to medical therapy.

For most patients, doctors will recommend lifestyle changes to lower your cholesterol before trying medication. Here are some to keep in mind:

• Be active. Regular physical activity can help boost your HDL, which will lower your LDL. Aim for 150 minutes of moderate-intensity aerobic activity each week (or about 20-25 minutes each day).
• Quit smoking. Smoking lowers your HDL (good cholesterol). Smoking can also raise your blood pressure, which increases your risk of heart disease even more.
• Drop some pounds. Being overweight or obese can lower your HDL and hike your LDL. Even losing 10 percent of your body weight can help.

When was the last time you had your cholesterol checked? Make an appointment with your physician for a check-up if you don’t have one on the books soon.

Your heart is in good hands when you choose us for cardiovascular care. Learn more about our high-quality heart care.

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