6
Treatment
Table 4. Recommendations for Treatment of Blood
Cholesterol to Reduce Atherosclerotic
Cardiovascular Risk in Adults—Statin Treatment
(continued)
(High-, moderate-, and low-statin intensities are defined in Table 2)
Recommendations
Î 4. For individuals ≥21 years of age with an untreated primary LDL-C
≥190 mg/dL, after the maximum intensity of statin therapy has
been achieved, addition of a nonstatin drug may be considered to
further lower LDL-C. Evaluate the potential for ASCVD risk-reduction
benefits, adverse effects, drug–drug interactions, and consider
patient preferences. (IIb-C)
Primary Prevention in Individuals With Diabetes and LDL-C 70-189 mg/dL
Î 1. Moderate-intensity statin therapy should be initiated or
continued for adults 40-75 years of age with diabetes mellitus. (I-A)
Î 2. High-intensity statin therapy is reasonable for adults 40-75 years
of age with diabetes mellitus with a ≥7.5% estimated 10-year ASCVD
risk
e
unless contraindicated. (IIa-B)
Î 3. In adults with diabetes mellitus, who are <40 or >75 years of
age or with LDL-C <70 mg/dL, it is reasonable to evaluate the
potential for ASCVD benefits and for adverse effects and drug–drug
interactions and to consider patient preferences when deciding to
initiate, continue, or intensify statin therapy. (IIa-C)
Primary Prevention in Individuals Without Diabetes and
With LDL-C 70-189 mg/dL
Î 1. The Pooled Cohort Equations should be used to estimate
10-year ASCVD risk
e
for individuals with LDL-C 70-189 mg/dL
without clinical ASCVD
a
to guide initiation of statin therapy for the
primary prevention of ASCVD. (I
c
-B)
Î 2. Adults 40-75 years of age with LDL-C 70-189 mg/dL, without
clinical ASCVD
a
or diabetes, and with an estimated 10-year ASCVD
risk
e
≥7.5% should be treated with moderate- to high-intensity statin
therapy. (I
d
-A)
Î 3. It is reasonable to offer treatment with a moderate-intensity statin
to adults 40-75 years of age, with LDL-C 70-189 mg/dL, without
clinical ASCVD
a
or diabetes and an estimated 10-year ASCVD risk
e
of
5% to <7.5%. (IIa-B)
