| Risk Group | Intensity of Therapy | Desired LDL-C Lowering |
| Moderate ASCVD | Moderate Intensity Statin | 30-50% |
| Established ASCVD or DM + 10 year risk > 7.5% | High-intensity statin | >50% |
High-Intensity Statins
- atorvastatin – 40-80 mg
- rosuvastatin – 20-40 mg
Moderate Intensity Statins
- atorvastatin – 10-20 mg
- rosuvastatin – 5-10 mg
- simvastatin – 20-40 mg
- pravastatin – 40-80 mg
- lovastatin – 40 mg
- fluvastatin – 80 mg
- pitavastatin – 2-4 mg
Goals:
- Total cholesterol: <200 mg/dl
- Triglycerides: <150 mg/dl
- HDL men >=40, women >=50
When to start therapy:
- LDL over 190 mg/dl
- LDL 70-189 and age 40-75 if:
- Diabetes
- 10-year ASCVD risk = 7.5% or more
- recalculate score for ages 40-75 every 4-6 years
- Only target triglycerides if over 500.
- Increases in TGs caused by obesity, alcohol use, beta-blockers, olanzapine, and diabetes
- Increased LDL is associated with gout