High-Potency Statins Found Most Effective in Lowering Bad Cholesterol: Study

LDL, or low-density lipoprotein cholesterol, commonly known as "bad" cholesterol, is a major contributor to clogged arteries and cardiovascular events. Researchers analyzed a comprehensive body of randomized trial data and concluded that high-potency statins have the “strongest and most consistent body of evidence” for both prevention and treatment—across genders and age groups.

The authors, including senior author Dr. Charles H. Hennekens, highlighted the importance of starting treatment with maximum statin doses and reducing only if necessary. “Practicing cardiologists may wish to consider that all adjunctive drug therapies to therapeutic lifestyle changes should be added only after achieving maximal doses of statins,” said Hennekens.

While statins remain central, the editorial also underscores the continued value of lifestyle changes such as quitting smoking, maintaining a healthy weight, managing blood pressure, increasing physical activity, and limiting alcohol intake. However, many high-risk individuals remain underdiagnosed and undertreated.

The authors offered cautious support for adjunctive therapies like ezetimibe and evolocumab, noting these may benefit only select high-risk patients who don't reach LDL goals with statins alone. Similarly, they acknowledged mixed findings around omega-3 fatty acids, with icosapent ethyl being the only formulation to show significant benefit in modern trials such as REDUCE-IT.

In conclusion, the researchers advocate a prevention-first approach.

Reference: John Dunn, Charles H. Hennekens. Low density lipoprotein (LDL) and beyond in the treatment and prevention of cardiovascular disease. Trends in Cardiovascular Medicine, 2025; DOI: 10.1016/j.tcm.2025.07.005