Cholesterol is a fatty substance that is found in the blood. In small amounts, it is important for the normal functioning of the body.

However, when there is too much cholesterol in the blood, it can build up in the arteries and lead to cardiovascular diseases such as heart attack and stroke. High cholesterol is a common problem among people all over the world. In fact, it is estimated that more than 95 million adults in the United States have total cholesterol levels higher than 200 mg/dL.

What Is High Cholesterol?

High cholesterol, also called hypercholesterolemia, is a condition in which there are elevated levels of cholesterol in the blood.

There are two main types of cholesterol that are measured in the blood: LDL (low-density lipoprotein) cholesterol and HDL (high-density lipoprotein) cholesterol. LDL cholesterol is often referred to as “bad” cholesterol because it can build up in the arteries and contribute to the development of cardiovascular disease.

HDL cholesterol, on the other hand, is often referred to as “good” cholesterol because it helps remove LDL cholesterol from the blood.

Why Is High Cholesterol Dangerous?

High cholesterol is dangerous because it can lead to the buildup of plaque in the arteries. This buildup can restrict blood flow to the heart, brain, and other organs, putting people at risk for heart disease, stroke, and other cardiovascular diseases.

In addition to the health risks, high cholesterol can also lead to other complications such as xanthomas (yellow deposits of fat under the skin) and pancreatitis (inflammation of the pancreas).

Treatments for High Cholesterol

There are several ways to lower cholesterol levels, including lifestyle changes and medication. Lifestyle changes that can help lower cholesterol levels include:.

Eating a healthy diet that is low in saturated and trans fats
Exercising regularly
Maintaining a healthy weight
Quitting smoking

Medications that can help lower cholesterol levels include:.

Statins
Ezetimibe
PCSK9 inhibitors
Fibrates
Niacin

The Promise of PCSK9 Inhibitors

PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors are a new class of medications that are used to treat high cholesterol. PCSK9 is a protein that regulates the amount of LDL cholesterol in the blood.

By blocking PCSK9, these medications can lower LDL cholesterol levels and reduce the risk of cardiovascular disease.

The first PCSK9 inhibitor to gain approval from the U.S. Food and Drug Administration (FDA) was alirocumab, which was approved in 2015. A second PCSK9 inhibitor, evolocumab, was approved that same year.

How PCSK9 Inhibitors Work

PCSK9 inhibitors work by blocking the PCSK9 protein from binding to LDL receptors on the liver. When this binding process is blocked, more LDL receptors are available to remove LDL cholesterol from the blood.

By lowering LDL cholesterol levels, these medications can help reduce the risk of heart attack, stroke, and other cardiovascular diseases.

Clinical Trials Results

Clinical trials have shown that PCSK9 inhibitors can significantly lower LDL cholesterol levels in patients with high cholesterol who are already taking statin medications.

In one trial, patients who took alirocumab in addition to a statin had a 62% reduction in LDL cholesterol levels compared to patients who took a placebo in addition to a statin. In another trial, patients who took evolocumab in addition to a statin had a 60% reduction in LDL cholesterol levels compared to patients who took a placebo in addition to a statin.

Potential Side Effects

The most common side effects of PCSK9 inhibitors are injection site reactions, such as redness, pain, and swelling.

More serious side effects are rare, but can include allergic reactions, liver problems, and neurocognitive problems such as confusion and memory loss.

Conclusion

PCSK9 inhibitors are a new class of medications that have shown great promise for the treatment of high cholesterol. They work by blocking the PCSK9 protein and increasing the number of LDL receptors available to remove LDL cholesterol from the blood.

Clinical trials have shown that these medications can significantly lower LDL cholesterol levels in patients with high cholesterol who are already taking statin medications. While there are potential side effects associated with PCSK9 inhibitors, they are generally well-tolerated and can provide an effective treatment option for people with high cholesterol.