Fast Five Quiz: Cardiovascular Disease Primary Prevention

Yasmine S. Ali, MD


March 06, 2023

The current AHA/ACC guideline states that for patients with ASCVD, high-intensive statin therapy should be used to achieve at least a 50% reduction in LDL cholesterol unless otherwise contraindicated or unless a patient experiences a statin-associated adverse event. In that case, doctors should use a moderate-intensity statin. A patient younger than 75 years with LDL-cholesterol levels ≥ 190 mg/dL, a 10-year risk for ASCVD greater than 7.5%, and no contraindications should receive a high-intensity statin, with the goal of achieving at least a 50% reduction in LDL cholesterol levels.

However, for patients older than 75 years and those with safety concerns and coronary artery disease, a moderate-intensity statin, defined as a drug that lowers LDL cholesterol by 30%-49%, can be used. For those with diabetes aged 40-75 years, a moderate-intensity statin should be used, whereas a high-intensity statin is a reasonable choice if the patient also has a 10-year risk for ASCVD exceeding 7.5%.

For a patient aged 40-75 years without cardiovascular disease or diabetes who has a 10-year risk for clinical events greater than 7.5% and an LDL cholesterol level of 70-189 mg/dL, the panel recommends treatment with a moderate- or high-intensity statin.

Learn more about the AHA/ACC guidelines.


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