Before initiating statin therapy, it is reasonable for clinicians and patients to engage in a discussion about the potential for ASCVD risk-reduction benefits, adverse events, drug-drug interactions, and patient preferences. If the 10-year risk of ASCVD is 5% to less than 7.5%, treatment with a moderate-intensity statin is reasonable. In persons 40 to 75 years of age without clinical ASCVD or diabetes and with an estimated 10-year ASCVD risk of 7.5% or greater, moderate- to high-intensity statin therapy should be used. The Pooled Cohort Equations should be used to estimate the 10-year ASCVD risk in persons without clinical ASCVD to guide initiation of statin therapy.
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HIGH INTENSITY STATINS FULL
If there are muscle or other symptoms, establish that they are related to the statin (COE = IIa LOE = B)įor specific recommendations on managing muscle symptoms, see Table 8 in full guideline In individuals intolerant of the recommended intensity of statin therapy, use the maximally tolerated intensity of statin (COE = I LOE = B) Regularly monitor adherence to lifestyle and drug therapy every 3 to 12 months after adherence has been established continue assessment of adherence for optimal ASCVD risk reduction and safety (COE = I LOE = A)
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Primary prevention: primary LDL-C ≥ 190 mg per dL (4.92 mmol per L) Initiate or continue appropriate intensity of statin therapyĪge ≤ 75 years and no safety concerns: high-intensity statin (COE = I LOE = A)Īge > 75 years or safety concerns: moderate-intensity statin (COE = I LOE = A) Encourage heart-healthy lifestyle habits for all individuals