Which drugs are considered first-line therapy for hyperlipidemia?

Statins are identified as first-line therapy for hyperlipidemia due to their proven efficacy in lowering low-density lipoprotein cholesterol (LDL-C) levels and reducing the risk of cardiovascular events. They work by inhibiting the enzyme HMG-CoA reductase, which plays a central role in cholesterol biosynthesis in the liver. This action leads to a significant reduction in the production of cholesterol and an increase in the uptake of LDL from the bloodstream, thereby lowering overall LDL levels.

Clinical guidelines from various health organizations recommend statins as the primary treatment for individuals with elevated cholesterol levels, particularly those with established cardiovascular disease or those at high risk. Their benefits extend beyond lowering cholesterol; statins also exhibit favorable effects on endothelial function and have anti-inflammatory properties, contributing to cardiovascular protection.

Although other medications like fibrates, bile acid sequestrants, and niacin may also play a role in the management of hyperlipidemia, they are generally considered second-line or adjunctive therapies. Statins are more extensively studied, with robust evidence supporting their use, making them a cornerstone in the management of dyslipidemia and cardiovascular risk reduction.