What is the efficacy of statins vs. fibrates in reducing hyperlipidemia?
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Last updated: November 22, 2025 • View editorial policy
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Statins:
- Primary Role: Statins are highly effective in lowering LDL-C (low-density lipoprotein cholesterol) levels.
- Efficacy: They can achieve a reduction of over 50% in LDL-C at high doses and 30-50% at moderate doses.
- Additional Effects: Statins have minimal impact on raising HDL-C (high-density lipoprotein cholesterol) and reducing triglycerides (TG) [1] [4].
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Fibrates:
- Primary Role: Fibrates primarily target triglyceride levels and can enhance HDL-C levels.
- Efficacy: They are particularly beneficial for patients with high triglycerides and low HDL-C, often seen in metabolic syndrome and mixed dyslipidemia.
- Limitations: Fibrates have minimal effects on LDL-C levels and their cardiovascular benefits are less established compared to statins [2] [5].
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Combination Therapy:
- Rationale: Combining statins with fibrates can provide complementary benefits, particularly in patients with mixed dyslipidemia, by effectively lowering LDL-C while also addressing high triglycerides and low HDL-C [3] [5].
- Clinical Recommendation: This combination is recommended for patients with high residual cardiovascular risk despite statin therapy alone [3] [4].
Clinical Bottom Line: Statins are the first-line treatment for lowering LDL-C, while fibrates are more effective for managing triglycerides and improving HDL-C. Combination therapy may be beneficial for patients with mixed dyslipidemia.