Statins work by inhibiting the HMG-CoA reductase enzyme in the liver, which plays a crucial role in the synthesis of cholesterol. Bile acid sequestrants bind to bile acids in the intestine, preventing their reabsorption and forcing the liver to use more cholesterol to produce bile. Cholesterol absorption inhibitors prevent the absorption of cholesterol from the intestine. PCSK9 inhibitors are newer agents that help lower cholesterol by increasing the liver's ability to remove LDL cholesterol from the blood. Fibrates primarily lower triglycerides and can modestly increase HDL cholesterol.
