A 65-year-old man with a 21% 10-year ASCVD risk should receive which type of statin therapy?

A 65-year-old man with a 21% 10-year ASCVD risk should receive which type of statin therapy?

• A. Moderate-intensity statin
• B. No statin needed
• C. Low-intensity statin
• D. Initiate high-intensity statin

Answer: (D)

In primary prevention, when a patient’s 10-year ASCVD risk is 20% or higher, high-intensity statin therapy is recommended because it achieves the largest reduction in LDL and the greatest drop in ASCVD events. A 65-year-old with a 21% risk falls into this high-risk category, so the goal is substantial LDL lowering (about 50% or more). Moderate-intensity statin would reduce risk but not as much, and low-intensity or no statin would miss the opportunity for the best preventive benefit. High-intensity options include atorvastatin 40–80 mg or rosuvastatin 20–40 mg, with ongoing monitoring for tolerance and side effects.

In primary prevention, when a patient’s 10-year ASCVD risk is 20% or higher, high-intensity statin therapy is recommended because it achieves the largest reduction in LDL and the greatest drop in ASCVD events. A 65-year-old with a 21% risk falls into this high-risk category, so the goal is substantial LDL lowering (about 50% or more). Moderate-intensity statin would reduce risk but not as much, and low-intensity or no statin would miss the opportunity for the best preventive benefit. High-intensity options include atorvastatin 40–80 mg or rosuvastatin 20–40 mg, with ongoing monitoring for tolerance and side effects.