An expert panel has recommend that the Food and Drug Administration approve a new type of cholesterol lowering drug which appears to have an additive effect above and beyond the statins according to Dr. Steven Reisman a Cardiologist in Manhattan. This new class of medicines called PCSK-9 inhibitors work by increasing the removal of cholesterol from the blood by the liver. More than 73 million Americans (about 1/3 of the total US adult population) have increased LDL cholesterol which is a major risk factor for heart attack and stroke.

The advantage of this new class of medications is that they have an additive effect in lowering cholesterol in addition to statins which are presently the main therapy. Statins work by decreasing the level of cholesterol production by the liver. Statins may also work by improving endothelial (inner lining of the arteries) function, decreasing the inflammatory response,   maintaining stability of plaques in the arteries, and preventing clot formation. Another advantage of this new class of medications is that there may be less side effects compared to statins. The disadvantages of this new class of drugs are that they may significantly increase the cost of treatment and they also at present require twice monthly injection by the patient.

The best initial approach in prevention of heart attack and stroke is lifestyle modification according to Dr. Steven Reisman, the Director of The New York Cardiac Diagnostic Center and a Cardiologist in New York City. This lifestyle modification includes adequate exercise and a heart healthy diet such as a Mediterranean diet. In addition, initial testing and screening to evaluate the risk of heart attack and stroke can be helpful in guiding future therapy.