Figure 1.

Mechanism of action of lipid-lowering medications. The major pathways of lipoprotein metabolism are shown along with the site and mechanism of action of lipid-lowering drugs. Triglyceride (TG)-rich very low-density lipoproteins (VLDLs) are secreted by the liver and are transformed into LDL after lipolysis by LPL. LPL is inhibited by ANGPTL3/8 complex. LDL is cleared from the plasma by hepatic LDL receptors, which are downregulated by excess intracellular hepatic cholesterol and the binding to PCSK9 in the plasma. Excess LDL in plasma gets deposited in the wall of arterial vessels where it triggers atherosclerosis. (−) indicates downregulation of indicated pathway.