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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.
