By vgreene, 27 January, 2020 If adolescent w obesity related lipid disorder Intensify lifestyle darr calories 30 60min mod vigorous aerobic activity most days beyond usual obesity recommendations Lifestyle counseling beneficial for darr LDL C
By vgreene, 27 January, 2020 Mod intensity 30 49 LDL C lowering atorvastatin 10 or 20 mg rosuvastatin 5 or 10 mg simvastatin 20 40 mg pravastatin 40 or 80 mg lovastatin 40 or 80 mg fluvastatin XL 80 mg fluvastatin 40 mg bid pitavastatin 1 4 mg
By vgreene, 27 January, 2020 High intensity 50 LDL C lowering atorvastatin 40 or 80 mg rosuvastatin 20 or 40 mg
By vgreene, 27 January, 2020 Factor age DM specific risk factors other ASCVD risks in LDL lowering approach for primary prevention 1 ADA considers T1 and T2 similarly esp in presence of CVD risk factors 2 AACE considers DM to be an ASCVD equivalent 3 target LDL C
By vgreene, 27 January, 2020 75 yo If already on mod high intensity statin reasonable to continue Otherwise may be reasonable to start statin after discussing net benefits risks etc per ACC AHA1
By vgreene, 27 January, 2020 40 75 yo w LDL C 70 189 Mod intensity statin indicated If higher risk esp pts w multiple ASCVD risk factors1 or 50 75 yo high intensity statin reasonable to darr LDL C by 50 if inadequate add ezetimibe if high intensity not tolerated use mod intensity eze
By vgreene, 27 January, 2020 20 39 yo May be reasonable to start mod intensity statin if long standing DM 10y T2 20y T1 and or if major CVD risk factor s 1 albuminuria 30 mcg albumin mg Cr eGFR
By vgreene, 27 January, 2020 If inadequate response to max tolerated statin ezetimibe AACE specifies additional combos 2 ACC AHA specifies 1
By vgreene, 27 January, 2020 If inadequate control w/ drugs: LDL apheresis exists, refer to specialist