high cholesterol

High-cholesterol management focuses on reducing atherogenic particles—especially ApoB—with dietary changes or medication as appropriate. 1

• Dietary cholesterol: Its effect on blood cholesterol is debated: one discussion describes little or no effect, while another distinguishes dietary cholesterol from saturated fat, which can raise LDL in many people. Responses to diet vary, so monitoring lipid markers matters. 2 3
• Statins and ezetimibe: Statins inhibit cholesterol synthesis; the liver responds by increasing LDL receptors and clearing more LDL from circulation. Ezetimibe blocks a gut transporter involved in cholesterol absorption. 4
• PCSK9 inhibitors: PCSK9 promotes degradation of LDL receptors; inhibiting it preserves more receptors and helps clear LDL particles from circulation. 5
• ApoB: ApoB measures the number of LDL and VLDL particles and is described as more predictive of risk than LDL cholesterol. One target proposed for someone aiming to live to 100 is below 30 mg/dL; treatment targets depend on individual circumstances. 6 7
• CRP: High-sensitivity CRP is discussed as a marker of cardiovascular inflammation and a predictor of future heart attack risk. 8