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These studies suggest that cholesterol-lowering medicines include statins, Ezetimibe, Evolocumab, Rosuvastatin, oligonucleotide therapeutics, and various herbal medicinal products like guggul, fenugreek, red yeast rice, artichoke, avocado, red dragon fruit, soursop leaf water extract, and cranberry anthocyanins.
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Statins are the most commonly prescribed medications for lowering cholesterol. They work by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver. Statins can reduce low-density lipoprotein (LDL) cholesterol by about 20% to 45%. Some of the most widely used statins include:
Ezetimibe works by inhibiting the absorption of cholesterol in the intestines, targeting the Niemann-Pick C1-like 1 protein (NPC1L1). When used alone, it can lower LDL cholesterol by about 18%, and when combined with statin therapy, it can provide an additional 25% reduction.
PCSK9 inhibitors, such as Evolocumab, are monoclonal antibodies that prevent the degradation of LDL receptors in the liver, thereby enhancing the liver's ability to remove LDL cholesterol from the blood. Evolocumab can reduce LDL cholesterol by 53% to 56% from baseline.
A new class of cholesterol-lowering drugs involves chemically modified small interfering RNA (siRNA) conjugated to trivalent N-acetylgalactosamine. These oligonucleotide therapeutics work by destroying RNA before a protein is synthesized, offering a novel approach to lowering cholesterol levels.
Several herbal medicines have shown potential in lowering cholesterol levels. These include:
Traditional Chinese medicines, such as the Qijudihuang pill, have been used to treat various conditions, including hypercholesterolemia. These medicines work by modulating cholesterol metabolism, reducing oxidative stress, and regulating gut microbiota.
The landscape of cholesterol-lowering medications is diverse, ranging from widely used statins and ezetimibe to advanced therapies like PCSK9 inhibitors and emerging oligonucleotide therapeutics. Additionally, herbal and traditional Chinese medicines offer natural alternatives for managing cholesterol levels. Each of these treatments plays a crucial role in reducing the risk of cardiovascular diseases associated with high cholesterol.
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