Question

A 58-year-old man with no known cardiovascular disease attends for a periodic health review. His LDL-C is 3.5 mmol/L, HDL-C 1.0 mmol/L, triglycerides 1.8 mmol/L, and total cholesterol 5.9 mmol/L. His 10-year cardiovascular risk by the Canadian risk calculator is 22%. What is the most appropriate lipid management strategy according to Canadian Cardiovascular Society dyslipidaemia guidelines?

Accepted Answer

Start high-intensity statin therapy aiming for >=50% LDL-C reduction and LDL-C <1.8 mmol/L

Answer

Reassure him; no lipid-lowering therapy is indicated because he has no clinical cardiovascular disease

Answer

Recommend lifestyle modification alone and repeat his lipid profile in 3 years

Answer

Start a moderate-intensity statin aiming for LDL-C <3.5 mmol/L

Answer

Begin ezetimibe monotherapy and avoid statins because of potential muscle toxicity

Practice question