AUSTRALIANS who want to lower their cholesterol levels will now be encouraged to change their lifestyle before reaching for a pill, unless they have a significant risk of heart attack.

The Federal Government has become increasingly concerned that the highly effective and hugely popular variety of lipid-lowering drugs known as statins are being overused.

A million people, or 7 per cent of Australian adults, have been prescribed statins. Sold under brand names such as Lipitor, Zocor and Pravachol, they cost taxpayers $500 million a year in subsidies.

This month, tighter guidelines on prescribing statins were introduced by the National Heart Foundation and the Cardiac Society of Australia and New Zealand.

The guidelines mean that people with a high cholesterol level may not need to be automatically prescribed statins if their overall risk of a heart attack is low.

The emphasis will be on evaluation of overall risk which takes in factors such as known recognised cardiovascular disease, diabetes, obesity, significant family history and smoking as well as the ratio of good (HDL) cholesterol to bad (LDL) cholesterol.

For example, a young non-smoking woman with a level of 6.5 but no other risk factors would be encouraged to improve her lifestyle instead of taking lipid-lowering drugs.

But an overweight person with a level of 6 who also suffers from hypertension may be prescribed drug therapy immediately.

The Heart Foundation's Professor Andrew Tonkin, who chaired the guidelines group, said there was no question that statins were highly effective for people in high-risk categories.

Last week, a British study found statins reduced the risk of heart attack or stroke by one-third.

But Tonkin said doctors needed to look beyond ``arbitrary'' benchmarks such as cholesterol levels.

``We're trying to shift from just looking at cholesterol alone to looking at the company it keeps,'' he said.

REDUCING CHOLESTEROL NATURALLY

* Reduce saturated fat in your diet.

* Eat two fish meals a week.

* Eat more soluble fibre, which is found in fruit, vegies, grains and legumes.

* Stop smoking.

* Take a brisk 30-minute walk most days of the week.

My cholesterol level is above 5.5 mmol/L. Do I need to take lipid-lowering drugs?

Not necessarily. It depends on your overall risk of coronary heart disease.

　　From Healthy.net