The Medical Letter on Drugs and Therapeutics
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1506
Lipid-Lowering Drugs
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Revised 11/2/2016: In the Fibric Acid Derivatives section, the last sentence in the Efficacy paragraph has been changed to "...raise HDL-C levels." (instead of "...raise LDL-C levels.").

11/30/16: Please see addendum.

Lipid-lowering drugs should be taken indefinitely; when they are stopped, plasma lipoproteins return to pretreatment levels. HMG-CoA reductase inhibitors (statins) remain the drugs of choice for treatment of most patients who require lipid-lowering therapy.

STATINS — Statins block the rate-limiting step in cholesterol synthesis. The subsequent reduction in hepatic cholesterol causes upregulation of lowdensity lipoprotein (LDL) receptors, increasing uptake and clearance of LDL-cholesterol (LDL-C) from the blood. Statins also decrease very low-density lipoprotein cholesterol (VLDL-C) and triglyceride levels and modestly increase high-density lipoprotein cholesterol (HDL-C) levels. Other direct effects of statins or indirect effects of lowering cholesterol include improved endothelial function, decreased platelet aggregation, and reduced inflammation. Statins also decrease serum concentrations of C-reactive protein, a marker ... more      

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Title: Lipid-Lowering Drugs
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