Which class of lipid-lowering agents is typically used in combination therapy to reduce LDL?

Statins are the class of lipid-lowering agents that are most commonly used in combination therapy to effectively reduce low-density lipoprotein (LDL) cholesterol levels. This is primarily due to their mechanism of action, which involves inhibiting HMG-CoA reductase, an enzyme critical for cholesterol synthesis in the liver. By reducing the liver's cholesterol production, statins prompt the liver to increase the uptake of LDL from the bloodstream, leading to a decrease in overall LDL levels.

In combination therapy, statins are often paired with other lipid-lowering agents to enhance lipid profiles. For instance, they can be used alongside other agents to address residual cardiovascular risk, as statins primarily target LDL but may not significantly affect triglyceride levels or raise high-density lipoprotein (HDL) levels substantially. Combining statins with fibrates, for example, can help achieve more comprehensive lipid control, particularly in patients with mixed dyslipidemia.

While other agents like fibrates and bile acid sequestrants do contribute to LDL reduction, they are used less frequently in combination with statins compared to how commonly statins are utilized as the backbone of cholesterol-lowering therapy. Omega-3 fatty acids primarily target triglyceride levels and have a different role in lipid