Question of the Week # 397

397)  A 65 year old man with past medical history of Hypertension presents to your office to discuss his lipid profile results which were obtained two weeks ago.  He takes Losartan for his high blood pressure and is compliant with 2gm sodium diet. He smoked about 1 pack per day for the past 35 years. On examination, his blood pressure is 140/88 mm Hg. Reminder of physical examination is unremarkable. His fasting lipid panel reveals Total cholesterol 220 mg%, LDL-C 150mg%, Triglycerides 150mg%, HDL-C 40mg%. Which of the following is the most appropriate initial step?

A) Diet and lifestyle modifications alone

B) Diet, Lifestyle modification and Statin therapy

C) No Intervention

D) Omega 3 Fatty Acids

E) Repeat Lipid Panel in 3 months

7 Responses

  1. B) Diet, lifestyle modification and Statin therapy

  2. b

  3. B) Diet, Lifestyle modification and Statin therapy

    • Here the answer is B because his Framingham 10 year risk > 20%(same as CAD cholesterol goal) but its a bit complex to calcute it fast enough to answer this q so i guess u can say from the question that he has too many risk factors and based on your clinical judgement you can start drug therapy??

      • With so many risk factors, age, smoking – no need to calculate. That score is just to remember that it exists. Once you have so many risk factors ( which is what they will give on exam); the 10 year CAD risk will definitely be > 20% even when you calculate

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