Which lipid changes are expected with statin therapy such as simvastatin?

• A. Decrease LDL and triglycerides; Increase HDL
• B. Increase LDL and triglycerides; Decrease HDL
• C. No change in lipid profile
• D. Decrease HDL only

Answer: (A)

Statins block the liver’s cholesterol-making enzyme, which lowers hepatic cholesterol synthesis. The liver then upregulates LDL receptors and pulls more LDL cholesterol from the blood, producing a meaningful decrease in LDL levels. In addition, reducing hepatic VLDL production helps lower triglycerides modestly. HDL can rise slightly in many patients due to overall favorable shifts in lipoprotein metabolism, though this change is more variable. So the overall expected pattern with statin therapy is a decrease in LDL and triglycerides with a modest increase in HDL. The other patterns—LDL going up, triglycerides rising, or HDL decreasing—don’t align with how statins affect lipid metabolism.