Drugs that treat CVD!

There are 5 main groups of drugs used in treating hyperlipidemia and cardiovascular disease; which are HMG CoA reductase inhibitors or statins, niacin, fibrates, bile acid sequestrants and cholesterol absorption inhibitors.

1. HMG CoA reductase inhibitors (statins)
   They inhibit the first enzymatic step of cholesterol synthesis and act as the first line and more effective treatment for patient with elevated LDL cholesterol level. The therapeutic benefits of the statins are they can promote plaque stabilization, improvement of coronary endothelial function, inhibition of platelet thrombus formation, anti-inflammatory activity. The examples of statins are lovastatin, simvastatin, pravastatin, atorvastatin, fluvastatin, rosuvastatin.
2. Niacin
   It can help to reduce LDL cholesterol level and it is the most effective agent to increase HDL cholesterol levels. It is usually used in combination with statins. Niacin decrease LDL cholesterol by strongly inhibits lipolysis in the adipose tissue. However, the adverse effect of niacin is that it will cause an intense cutaneous flush and pruritus. Besides, it may also lead to hyperuricemia and gout.
3. Fibrates
   Fenofibrate and gemfibrozil are derivatives of fibric acid that help to lower serum triglyceride and increase HDL levels. However, fenofibrate is more effective is lowering LDL cholesterol and triglyceride level as compared to gemfibrozil. The adverse effects of fibrates are formation of gallstones, inflammation of muscle, and gastrointestinal distress.
4. Bile Acid Sequestrants (Resins)
   Cholestyramine, cloestipol and colesevelam are examples of resin that prevent bile acids from returning to the liver by enterohepatic circulation. The lowering of the bile acid concentration causes hepatocytes to increase conversion of cholesterol to bile acids, which decrease the level of cholesterol in the blood.
5. Cholesterol Absorption Inhibitors
   Ezetimibe inhibits intestinal absorption of cholesterol in the small intestine, causes a decrease in the delivery of intestinal cholesterol to the liver.