Hypocholesterolemic Agents Response to Colleague

RESPONSE

Reply to Katie about Hypocholesterolemic Agents

I found it interesting that lipoproteins have varying densities and they are thus classified as high-density lipoprotein, low-density lipoprotein, very low density lipoprotein, and chylomicrons. According to Centers for Disease Control and Prevention (2020), most of the cholesterol in the body happens to be the low-density lipoprotein. The said cholesterol is termed as ‘bad’ cholesterol owing to the fact that when its levels are high, the risk of stroke and heart disease rises. As highlighted by Katie, high density lipoproteins are in small amounts. According to CDC (2020), the said cholesterol transports excess cholesterol to the liver after absorbing it, which is then flushed out of the body. When levels of cholesterol are high in the body, hypocholesterolemic drugs are prescribed to help lower the said levels.

Katie opted to focus on statins and niacin as examples of drugs that can be prescribed to achieve the said effect. One thing that I was not aware of about statin is its mode of action. According to Ward et al. (2019), statin happens to be a first choice drug in lowering plasma LDL. The authors further suggest that statin lowers LDL by blocking its active site which is the mevalonate pathway. When the said pathway is blocked, HMG-CoA is blocked from converting to mevalonic acid. As a result, hepatic cholesterol synthesis is reduced leading to an increase in cell surface for expression of LDL receptor which facilitates the removal of LDL levels (Ward et al., 2019). I was also not aware that niacin, which is also a cholesterol-lowering agent, can also cause toxicity in the liver. Despite the fact that niacin inhibits triglyceride synthesis by increasing HDL and lowering LDL, niacin use can lead to toxicity (Djadjo, 2022). According to the author, nicotic acid which happens to be the crystalline form of niacin causes a flushing reaction in the liver, causing toxicity.