Which lipid-lowering class is often recommended for secondary prevention of cardiovascular events?

Statins are the lipid-lowering agents that are frequently recommended for secondary prevention of cardiovascular events, primarily due to their well-documented efficacy in reducing the risk of heart attacks and strokes in individuals with a history of cardiovascular disease. Statins work by inhibiting HMG-CoA reductase, an enzyme critical in the cholesterol biosynthesis pathway, leading to decreased levels of low-density lipoprotein (LDL) cholesterol in the bloodstream.

Multiple large-scale clinical trials have established that statin therapy significantly lowers the incidence of major adverse cardiovascular events, making them a cornerstone in the management of patients who have already experienced such events. This makes their role crucial for secondary prevention strategies in patients with established coronary artery disease, peripheral artery disease, or a history of stroke.

Other lipid-lowering agents, such as fibrates, bile acid sequestrants, and omega-3 fatty acids, have roles in managing lipid profiles but do not have the same robust evidence base for reducing cardiovascular events when compared with statins. While they may be utilized in specific scenarios or populations, they are not the primary agents recommended for secondary prevention.