Classes of hypolipidemic drugs

cardiovascular risk

Established

• statins are particularly well-suited for lowering LDL, the cholesterol with the strongest links to cardiovascular diseases. In studies using standard doses, statins have been found to lower LDL-C by 18% to 55%, depending on the specific statin being used. There is a risk of severe muscle damage (myopathy & rhabdomyolysis) with statins.
• fibrates are indicated for hypertriglyceridemia. Fibrates typically lower triglycerides by 20% to 50%. Level of the good cholesterol HDL is also increased. Fibrates may decrease LDL, though generally to a lesser degree than statins. Similar to statins, there's a risk of severe muscle damage (myopathy & rhabdomyolysis) with fibrates.
• niacin, like fibrates, is also well-suited for lowering triglycerides by 20-50%. It may also lower LDL by 5-25% and increase HDL by 15-35%. Niacin may cause hyperglycemia, and may also cause liver damage.
• bile acid sequestrants (resins) are particularly effective for lowering LDL-C by sequestering the cholesterol-containing bile acids released into the gut and preventing their reabsorption from the gut. It decreases LDL by 15-30% and raises HDL by 3-5%. It has little effect on triglycerides but can cause a slight increase. Bile acid sequestrants may cause gastrointestinal problems, and may also reduce the absorption of other drugs and vitamins from the gut.
• ezetimibe (Zetia) is a selective inhibitor of dietary cholesterol absorption.
• phytosterols may be found naturally in plants. Similar to ezetimibe, phytosterols reduce the absorption of cholesterol in the gut. Hence, they're most effective when consumed with meals. However, the precise mechanism of action of phytosterols differs from ezetimibe.
• Orlistat (Xenical):Its primary function is to prevent the absorption of about 30%of fats from the human diet; thereby reducing caloric intake (a drug designed to treat obesity) is by inhibiting Pancreatic lipase- an enzyme that breaks down triglycerides in the intestine.

Investigational