Cholesterol is a waxy, fat-like substance that occurs naturally in your body and is essential for proper cell function. While your liver produces most of the cholesterol your body needs, it's also found in foods from animal sources. Understanding cholesterol levels is crucial for maintaining cardiovascular health and preventing heart disease.
Not all cholesterol is created equal. High-density lipoprotein (HDL) is often called "good" cholesterol because it helps transport cholesterol away from your arteries to your liver for disposal. Low-density lipoprotein (LDL), known as "bad" cholesterol, can build up in artery walls, forming plaques that may lead to heart attacks or strokes.
In Australia, cholesterol levels are measured through a simple blood test, typically after fasting for 9-12 hours. Results are expressed in millimoles per litre (mmol/L). The recommended targets for Australian adults include total cholesterol below 5.5 mmol/L, LDL cholesterol below 3.5 mmol/L, and HDL cholesterol above 1.0 mmol/L for men and 1.3 mmol/L for women.
Several factors contribute to high cholesterol, including family history, age, diet, physical inactivity, obesity, smoking, and certain medical conditions. While genetics play a significant role, lifestyle modifications can substantially impact your cholesterol levels.
Australian pharmacies stock various cholesterol-lowering medications, each working through different mechanisms to help patients achieve optimal cholesterol levels. The choice of medication depends on individual health factors, cholesterol levels, and response to treatment.
Statins remain the gold standard for cholesterol management and are the most frequently prescribed medications in Australia. These drugs work by blocking an enzyme your liver needs to produce cholesterol, effectively reducing LDL levels by 20-60%. Common statins available include atorvastatin, simvastatin, and rosuvastatin.
For patients who cannot tolerate statins or need additional cholesterol reduction, several alternatives are available:
Both generic and brand name options are widely available through Australian pharmacies, with many medications listed on the Pharmaceutical Benefits Scheme (PBS) to help reduce costs for patients.
Atorvastatin (Lipitor) remains one of the most prescribed cholesterol medications in Australia, typically taken as a 20-40mg daily dose. It effectively reduces LDL cholesterol by up to 50% and has proven cardiovascular benefits. Rosuvastatin (Crestor) offers potent cholesterol-lowering effects with once-daily dosing, making it ideal for patients requiring significant LDL reduction.
Simvastatin provides a cost-effective statin option, particularly beneficial for budget-conscious patients, whilst Pravastatin offers a gentler alternative for those experiencing muscle-related side effects with other statins.
Ezetimibe (Ezetrol) works differently by blocking cholesterol absorption in the intestines, making it suitable for patients who cannot tolerate statins. Fenofibrate specifically targets elevated triglyceride levels and is often prescribed alongside statins for comprehensive lipid management.
Most cholesterol medications receive PBS subsidies, significantly reducing costs for eligible patients. Additional support includes:
Statins work by inhibiting HMG-CoA reductase, the key enzyme responsible for cholesterol production in the liver. This blockade forces the liver to remove existing cholesterol from the bloodstream, effectively lowering overall cholesterol levels whilst providing anti-inflammatory benefits to blood vessel walls.
Different medication classes target various aspects of cholesterol metabolism. Patients typically see initial improvements within 2-4 weeks, with maximum effects achieved after 6-8 weeks of consistent treatment. Regular blood tests every 6-12 weeks initially help monitor medication effectiveness and adjust dosages accordingly.
Your pharmacist will coordinate with your GP to ensure optimal cholesterol management through regular lipid profile testing, tracking total cholesterol, LDL, HDL, and triglyceride levels throughout your treatment journey.
Cholesterol medications, particularly statins, are generally well-tolerated but may cause side effects in some patients. The most common adverse reactions include muscle pain, weakness, digestive issues, and occasional headaches. Muscle-related symptoms, known as myopathy, affect approximately 5-10% of patients and can range from mild discomfort to severe weakness.
It's crucial to consult your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness, especially if accompanied by fever or dark-coloured urine. Regular liver function tests are typically required, particularly during the first few months of treatment, as some cholesterol medications can affect liver enzymes.
For patients who cannot tolerate statins, alternative options include ezetimibe, bile acid sequestrants, or newer PCSK9 inhibitors. Your GP can adjust dosages or switch medications to minimise side effects while maintaining cardiovascular protection.
Cholesterol medications work most effectively when combined with heart-healthy lifestyle changes. Focus on a Mediterranean-style diet rich in fruits, vegetables, whole grains, and lean proteins whilst limiting saturated fats and processed foods. Regular physical activity, such as 150 minutes of moderate exercise weekly, significantly enhances medication effectiveness and overall cardiovascular health.
Regular monitoring through blood tests every 6-12 months helps ensure optimal cholesterol levels and medication safety. Schedule regular reviews with your GP to assess progress and adjust treatment as needed. Your pharmacist is an excellent resource for medication queries, potential interactions, and adherence support.
For additional support, contact the Heart Foundation Australia or speak with your local pharmacist about medication management services. Many community health centres also offer cardiovascular risk assessment programmes to complement your treatment plan.
