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Cholesterol

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1 Î Use the newly developed Pooled Cohort Equations for estimating 10-year ASCVD risk. Calculating the estimated 10-year ASCVD risk should be the start of the clinician-patient discussion and should not automatically lead to statin initiation . • For other ethnic groups, use the equations for non-Hispanic whites, although these estimates may underestimate the risk for persons from some race/ethnic groups, especially American Indians, some Asian Americans (e.g., of south Asian ancestry), and some Hispanics (e.g., Puerto Ricans), and may overestimate the risk for others, including some Asian Americans (e.g., of east Asian ancestry) and some Hispanics (e.g., Mexican Americans). Î Initiate the appropriate intensity of statin therapy to reduce ASCVD risk. Î Evidence is inadequate to support treatment to specific LDL-C or non–HDL-C treatment goals. "Treating to goal" may result in treatment with less-than-optimum statin intensity or adding unproven nonstatin therapy. Î Regularly monitor patients for adherence to lifestyle and appropriate intensity of statin therapy. Obtain a fasting lipid panel before and after initiating statin or other drug therapy. Î Nonstatin drug therapy may be considered in selected individuals.

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