Which class of lipid-lowering agents works by inhibiting HMG-CoA reductase?

The class of lipid-lowering agents that works by inhibiting HMG-CoA reductase is statins. Statins are integral in the management of hyperlipidemia due to their mechanism of action, which involves the competitive inhibition of the enzyme HMG-CoA reductase. This enzyme plays a crucial role in the mevalonate pathway, which is responsible for cholesterol synthesis in the liver. By inhibiting this enzyme, statins effectively reduce the liver's production of cholesterol, leading to a decrease in circulating LDL cholesterol levels.

In addition to lowering LDL cholesterol, statins also have other beneficial effects; they can stabilize atherosclerotic plaques and have anti-inflammatory properties, making them important in reducing cardiovascular risk. These effects enhance their role beyond mere cholesterol lowering, positioning them as first-line therapy in lipid management.

Understanding the specific action of statins helps to differentiate them from other lipid-lowering agents. For example, fibrates primarily lower triglyceride levels and can also modestly increase HDL cholesterol, but they do not inhibit HMG-CoA reductase. Bile acid sequestrants work by binding bile acids in the intestine, leading to increased cholesterol metabolism to replace the bound bile acids, while niacin affects lipid levels primarily by decreasing hepatic