Which class of drugs is primarily used to achieve the LDL cholesterol goal in patients with established ASCVD?

• A. Statins
• B. ACE Inhibitors
• C. Diuretics
• D. Beta Blockers

Answer: (A)

Lowering LDL cholesterol in people with established ASCVD is best achieved with statin therapy. Statins inhibit HMG-CoA reductase, the liver’s key enzyme in cholesterol synthesis, which lowers hepatic cholesterol and causes upregulation of LDL receptors. That combination pulls more LDL particles out of the blood, producing a substantial and well-proven drop in LDL-C and, importantly, a reduction in recurrent cardiovascular events. In high-risk patients, guidelines push for very low LDL targets and use high-intensity statin therapy to reach them. If statins aren’t tolerated or LDL goals aren’t met, non-statin agents can be added, but the primary tool remains the statin. The other drugs listed—ACE inhibitors, diuretics, and beta blockers—are used to manage blood pressure, fluid status, or heart rate and symptoms, not to lower LDL cholesterol.