{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:58:04Z","timestamp":1787025484031,"version":"build-2736575974"},"reference-count":100,"publisher":"IMR Press","issue":"4","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Low-density lipoprotein-cholesterol (LDL-C) is a causal factor in atherosclerotic cardiovascular disease (ASCVD). Decades of genetic, epidemiological and randomised evidence support LDL-C reduction as a central strategy for cardiovascular risk reduction. Statins remain the first choice of LDL-C-lowering therapy due to their proven efficacy and favourable safety profile. However, therapeutic options have now expanded with widespread availability of other agents including ezetimibe, bempedoic acid and proprotein convertase subtilisin\/kexin type 9 (PCSK9) inhibitors. These can be prescribed alone or in combination with statins to help achieve optimal LDL-C targets. More recently, RNA-based therapies, oral small molecule inhibitors, and gene-editing strategies have emerged, which may offer even greater LDL-C reduction. As evidence increasingly supports a \u201clower is better\u201d approach, combining established and novel therapies offers opportunities to optimise ASCVD prevention. This review summarises the evolving landscape of LDL-C-lowering therapies, highlighting their mechanisms, evidence base, and implications for clinical practice.<\/jats:p>","DOI":"10.31083\/bjhm53219","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:17:23Z","timestamp":1777457843000},"source":"Crossref","is-referenced-by-count":1,"title":["LDL-Cholesterol Lowering Therapies: An Update"],"prefix":"10.31083","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0273-1829","authenticated-orcid":true,"given":"Robert","family":"Humphrey","sequence":"first","affiliation":[{"name":"Clinical Trial Service Unit, Oxford Population Health, University of Oxford, OX3 7LF Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1125-8616","authenticated-orcid":true,"given":"Louise","family":"Bowman","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit, Oxford Population Health, University of Oxford, OX3 7LF Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. 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