Treatment Guidelines from The Medical Letter
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103
Drugs for Lipids
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Updated March 2012

Drugs that lower low-density lipoprotein cholesterol (LDL-C) concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions. Lipid-regulating drugs must be taken indefinitely; when they are stopped, plasma lipoproteins return to pretreatment levels in 2-3 weeks.

STATINS — HMG-CoA reductase inhibitors (statins) inhibit the enzyme that catalyzes the rate-limiting step in cholesterol synthesis. The subsequent reduction in hepatic cholesterol leads to increased LDL receptor activity and increased clearance of LDL-C from the blood. Statins are more effective than other drugs in lowering LDL-C, and they also lower triglycerides. Most statins increase high-density lipoprotein cholesterol (HDL-C), but only modestly.

Statins also have other effects: they improve endothelial function, decrease platelet aggregation and reduce inflammation. Statins decrease serum concentrations of ... more      

The Medical Letter is a subscriber-funded nonprofit organization that publishes critical appraisals of new prescription drugs and comparative reviews of drugs for common diseases.

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