Which lipid-lowering agent is commonly prescribed for primary prevention and lowers LDL?

• A. Fibrates
• B. Statins
• C. Niacin
• D. Bile acid sequestrants

Answer: (B)

Statins are the most effective and commonly prescribed option for primary prevention when the goal is to lower LDL cholesterol. They work by inhibiting HMG-CoA reductase, the enzyme involved in liver cholesterol synthesis. This decrease prompts the liver to increase LDL receptors, pulling more LDL from the bloodstream and producing a meaningful drop in LDL-C—often 30% to 50% or more depending on the dose. That substantial reduction translates into a real drop in the risk of heart attack and stroke even in people without existing cardiovascular disease. Other agents can lower LDL or address triglycerides, but they don’t offer the same combination of strong LDL lowering and proven outcomes in primary prevention, and they may have tolerability or interaction drawbacks. Therefore, statins are the go-to choice for reducing LDL in this setting.