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🌱 來自: 2018 ACC AHA Cholesterol Guidelines

primary prevention of clinical ASCVD in patients at increased risk but who have not had a vascular event

LDL-C >190 mg/dL

• No risk assessment, commence high- or maximally tolerated intensity statin
• Rule out secondary causes of hyperlipidemia

Diabetes mellitus age 40–75 LDL-C <190 mg/dL

• Commence moderate-intensity statin with consideration for high-intensity statin based on ASCVD risk assessment

No diabetes mellitus age 40–75 LDL-C <190 mg/dL

Calculate 10-year ASCVD risk percent to begin discussion:

1. <5% (low risk): diet and lifestyle factors
2. 5%–7.5% (borderline risk): if risk enhancers present consider moderate-intensity statin
3. 7.5%–20% (intermediate risk): if risk enhancers present initiate moderate-intensity statin to reduce LDL-C by 30%–49%

4. 20% (high risk): initiate statin to achieve LDL-C reduction of at least 50%