High-intensity statins (rosuvastatin, atorvastatin)

HMG-CoA reductase inhibitors that reduce hepatic cholesterol synthesis, increasing LDL receptor expression and lowering circulating LDL-C. Also have anti-inflammatory and plaque-stabilizing effects beyond lipid lowering (pleiotropic effects). The foundational pharmacotherapy for atherosclerosis prevention and treatment.

2026 ACC/AHA guideline: high-intensity statin targeting LDL-C <70 mg/dL for most ASCVD patients, <55 mg/dL for very-high-risk. Rosuvastatin 20–40 mg or atorvastatin 40–80 mg daily.

pharmaceutical