Can the damage be prevented, stopped, or reversed?

We know that high cholesterol can damage the blood vessels, leading to health problems such as heart attack and stroke (to learn more, see "How high cholesterol affects your blood vessels"). But can the damage be prevented, stopped, or reversed?

According to Dr. Stephen Fort, Staff Cardiologist and Director of the Cardiac Catheterization Laboratory at Queen Elizabeth II Health Sciences Centre and Associate Professor of Medicine at Dalhousie University, the ideal way to deal with the risk of blood vessel damage is to prevent the damage from happening in the first place. There is a great deal of evidence to show that blood vessel damage can be prevented by reducing cholesterol to healthy levels.

This means sticking to the treatment plan your doctor recommends, which often includes both lifestyle changes and medications. By following your treatment plan over the long term, you can help keep your blood vessels healthy, and reduce your risk of complications associated with high cholesterol, such as heart attack and stroke. To learn more, see "Healthy blood vessels for life: Playing your part."

There is also some early evidence to suggest that treatment with certain medications may be able to halt or even reverse blood vessel damage related to high cholesterol. Recently, there have been a number of studies showing that aggressive treatment of cholesterol using medications known as "statins" resulted in positive effects. A few studies showed that the aggressive treatment slowed down the progression of blood vessel damage in people with heart disease. Another study showed that aggressively treating people with heart disease, again with a "statin," actually helped to reverse some their blood vessel damage.

Dr. Fort says that these are exciting times for research into ways to stop and prevent blood vessel damage, and this is an area of active investigation. He also points out that this evidence is still very early, and that these studies have only been designed to observe changes in blood vessels; they were not designed to detect if aggressive treatment lowered the chance of suffering from health complications such as heart attacks or strokes.

Depending on your situation, your doctor may recommend a procedure called coronary angiography, which is a procedure that uses a special dye and X-rays to highlight how your blood is flowing in the arteries supplying your heart. Therefore, it can identify blood vessels that have become narrowed or blocked. In some cases (e.g., for certain people with chest pain related to heart disease), your doctor may recommend an operation or procedure to relieve symptoms or reduce your need for medication.

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