Medications for High Cholesterol

High cholesterol (hypercholesterolemia) is a condition in which there is too much cholesterol — a waxy, fat-like substance — circulating in the blood. Cholesterol is carried through the bloodstream by proteins called lipoproteins: LDL ("bad") cholesterol can build up in artery walls, while HDL ("good") cholesterol helps remove excess cholesterol from the bloodstream. Risk factors include an unhealthy diet high in saturated and trans fats, physical inactivity, obesity, smoking, genetics (familial hypercholesterolemia), diabetes, and certain medications. High cholesterol by itself causes no symptoms, so most people are unaware they have it until a cardiovascular event occurs or a blood test reveals elevated levels. Nearly 94 million adults in the United States have elevated total cholesterol, according to the CDC.

Over time, excess LDL cholesterol contributes to the buildup of plaques inside arteries (atherosclerosis), narrowing the arteries and increasing the risk of heart attack and stroke. High triglycerides — another type of blood fat often elevated alongside high cholesterol — can further increase cardiovascular risk. Treatment begins with lifestyle changes: a heart-healthy diet low in saturated fat, regular aerobic exercise, weight loss, and quitting smoking. When lifestyle measures are insufficient, cholesterol-lowering medications are prescribed: statins are the most commonly used and work by blocking the liver's cholesterol production; bile acid sequestrants, fibrates, and newer agents like PCSK9 inhibitors provide additional options. The medications listed below are among the most commonly prescribed for managing high cholesterol and lowering cardiovascular risk.