What is the first-line medication for hyperlipidemia?

Statins are recognized as the first-line medication for managing hyperlipidemia, particularly in patients with elevated low-density lipoprotein (LDL) cholesterol levels. Their primary mechanism of action involves the inhibition of HMG-CoA reductase, an enzyme crucial for cholesterol synthesis in the liver. By lowering LDL cholesterol, statins effectively reduce the risk of cardiovascular events such as heart attacks and strokes.

Studies support the extensive use of statins due to their proven efficacy in both primary and secondary prevention of atherosclerotic cardiovascular disease. These medications are also associated with improvements in additional lipid parameters, such as increasing high-density lipoprotein (HDL) cholesterol and lowering triglycerides. Additionally, statins provide benefits beyond cholesterol reduction; they may stabilize atherosclerotic plaques and have anti-inflammatory effects.

In contrast, other classes of medications like beta-blockers, ACE inhibitors, and diuretics primarily address different cardiovascular conditions such as hypertension, heart failure, and arrhythmias, rather than directly targeting lipid levels. While they can play a supportive role in cardiovascular health, they are not the first choice for hyperlipidemia management.