Other Conditions
16
11. Hypogonadism and Testosterone Replacement and
Abuse
➤ 11.1 In patients with low testosterone levels, we suggest testosterone
therapy as symptomatically indicated, and not as an approach to improve
dyslipidemia or CVD risk. (2|⊕⊕
)
➤ 11.2 In patients with low HDL (<30 mg/dL [0.8 mmol/L]), especially in
the absence of hypertriglyceridemia, we advise clinical or biochemical
investigation of anabolic steroid abuse. (UGPS)
Technical Remark: Supraphysiological doses of androgens will reduce HDL-C levels.
12. Gender-Affirming Hormone Therapy
➤ 12.1 In transwomen and transmen who have taken or are taking gender-
affirming hormone therapy, we advise assessing CV risk by guidelines for
non-transgender adults. (UGPS)
Technical Remark: There are no data to guide selection of a gender marker in risk
calculators for individuals on gender-affirming hormone therapy.
Table 4. Statins: LDL-C Reduction by Dose, and Major Drug
Interactions
Statin
Estimated Percent LDL-C
Reduction by Dose Major Drug Interactions*
High
Intensity
≥50%
Moderate
Intensity
30–50%
Low
Intensity
<30%
Gemfibrozil should be avoided in
all statins
Atorvastatin 40 mg,
80 mg
10 mg,
20 mg
----- Clarithromycin, itraconazole,
colchicine, cyclosporine, niacin
Rosuvastatin† 20 mg,
40 mg
5 mg,
10 mg
----- Cyclosporine, darolutamide,
niacin
Simvastatin ----- 20 mg,
40 mg
10 mg Verapamil, diltiazem, amlodipine,
macrolide antibiotics,
amiodarone, dronedarone,
antifungal azoles, nefazodone,
danazol, ranolazine, colchicine,
cyclosporine, daptomycin, niacin
Pravastatin ----- 40 mg,
80 mg
10 mg,
20 mg
Macrolide antibiotics, colchicine,
cyclosporine
