A 44-year-old white woman treated for hypertension presents for advice on lipid treatment.
She smokes but is not diabetic and has no history of cardiovascular disease. Blood
pressure is 134/72 mm Hg and body mass index is 36.0. Fasting lipids reveal total
cholesterol 203 mg/dL, low-density-lipoprotein cholesterol (LDL-C) 95 mg/dL, triglycerides
350 mg/dL, and high-density-lipoprotein cholesterol (HDL-C) 38 mg/dL. Based on the
Pooled Cohort Risk Assessment Equations, this patient's 10-year atherosclerotic cardiovascular
disease risk is 7.3%. Her lifetime risk is 50%, or 6 times that of a 50-year-old white
woman with optimal risk factors. Her 10-year risk would not suggest treatment, but
her lifetime risk is concerning. In addition to smoking cessation, improved diet,
and routine exercise, a more in-depth discussion about statin therapy and possible
ancillary testing such as coronary artery calcium scoring or high-sensitivity C-reactive
protein (hs-CRP) to further stratify her risk may be warranted.
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Article info
Publication history
Published online: February 24, 2014
Footnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and participated in the writing of the manuscript.
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© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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