Maintenance dose: 5 mg to 40 mg orally once a day. In that analysis. Maintenance dose: 5 to 40 mg orally once a day. Guidelines for statin prescribing, particularly regarding the best dosing strategies, have been unclear. Statin should be considered in those with a family history of premature ASCVD and LDL-C ≥160 mg/dl. Initial dose: 10 to 20 mg orally once a day. T2DM and age 40-75 years, use moderate-intensity statin and risk estimate to consider high-intensity statins. Risk ≥7.5-20% (intermediate risk). Restricted Use (due to myopathy risk): 80 mg/day should only be used in patients who have been taking this drug chronically (e.g. The study defined low-intensity statin therapy as treatment with fluvastatin, 20 to 40 mg, lovastatin, 20 mg, simvastatin, 10 mg, pitavastatin, 1 mg, and pravastatin, 10 to 20 mg. Moderate-intensity statin therapy was defined as atorvastatin, 10 to 20 mg, fluvastatin, 40 mg twice a day or 80 mg once a day (extended-release formulation), lovastatin, 40 mg, pitavastatin, 2 to 4 mg, pravastatin, 40 to 80 mg, rosuvastatin, 5 to 10 mg, and simvastatin, 20 to 40 mg. The focus is primary prevention in adults to reduce the risk of ASCVD (acute coronary syndromes, myocardial infarction, stable or unstable angina, arterial revascularization, stroke/transient ischemic attack, peripheral arterial disease), as well as heart failure and atrial fibrillation. Atrial Fibrillation/Supraventricular Arrhythmias. Adults diagnosed as obese (body mass index [BMI] ≥30 kg/m. When choosing a statin dose, expected LDL reduction is not the only factor to consider. For decades, low-dose aspirin (75-100 mg with US 81 mg/day) has been widely administered for ASCVD prevention. Most important is to avoid aspirin in persons with increased risk of bleeding including a history of GI bleeding or peptic ulcer disease, bleeding from other sites, age >70 years, thrombocytopenia, coagulopathy, chronic kidney disease, and concurrent use of nonsteroidal anti-inflammatory drugs, steroids, and anticoagulants. A recent study, published in JAMA Cardiology, helped clarify the value of high dose statins. Impaired renal or … Adults should engage in at least 150 minutes/week of moderate-intensity or 75 minutes/week of vigorous-intensity physical activity including resistance exercise. A dosing strategy based on these trials would titrate the dose to an LDL target. Patients treated with higher doses had lower mortality and this was also true in the patients over 75 years of age. Risk discussion: if risk-enhancing factors are present, discuss moderate-intensity statin and consider coronary CACs in select cases. Risk-enhancers in diabetics include ≥10 years for T2DM and 20 years for type 1 DM, ≥30 mcg albumin/mg creatinine, eGFR <60 ml/min/1.73 m. Age >75 years, clinical assessment and risk discussion. † Previous guidelines recommended low-density lipoprotein cholesterol goal-directed statin therapy, but lipid testing and high-intensity statin use were infrequent after myocardial infarction. -High-risk patients may initiate at 40 mg orally once a day. Guidelines for statin prescribing, particularly regarding the best dosing strategies, have been unclear. This updated guideline focuses on reducing the risk of ASCVD in four statin benefit groups: (1) persons with clinical ASCVD (i.e., acute coronary syndromes, or a history of myocardial infarction, stable or unstable angina, coronary or other arterial revascularization, stroke, transient ischemic attack, or peripheral arterial disease of atherosclerotic origin); (2) persons with primary elevations of LDL-C levels of 190 mg per dL (4.92 mmol per L) or greater; (3) persons with diabetes mellitus who are 40 to 75 years o… Among options include the Mediterranean, DASH, and vegetarian/vegan diets that achieve weight loss and improve glycemic control. Parents can be reluctant to talk about race. There has been much conflicting and incomplete research data. The impact of higher vs. moderate dose of statins has been debated, and physicians and patients have often resisted starting treatment with higher doses, hoping to avoid side effects leading to discontinuation of the medication altogether. Initial dose: 10 mg to 20 mg orally once a day. If you have some form of atherosclerotic cardiovascular disease, including coronary artery disease, peripheral vascular disease or stroke, you may want to review your current medication treatment with your doctor to decide if you might benefit from a change. KDIGO Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease v Tables and Figures vi KDIGO Board Members vii Reference Keys viiii CKD Nomenclature ix Conversion Factors x Abbreviations and Acronyms 259 Notice 260 Foreword 261 Work Group Membership A meta-analysis of 61 prospective studies observed a log-linear association between SBP levels <115 to >180 mm Hg and DBP levels <75 to 105 mm Hg and risk of ASCVD. High cholesterol builds up in arteries causing plaques that narrow the passageways available for blood to flow freely to muscles and organs throughout the body. pravastatin or rosuvastatin); consider routine CK monitoring. The development and progression are heavily influenced by dietary pattern, physical activity, and body weight. Monitoring and managing cholesterol levels is a primary focus in preventing heart attacks and strokes. High-intensity statin therapy was defined as atorvastatin, 40 to 80 mg, or rosuvastatin, 20 to 40 mg. The following are guideline recommendations for statin treatment: Patients ages 20-75 years and LDL-C ≥190 mg/dl, use high-intensity statin without risk assessment.