Skip to content Cholesterol Treatment Guidelines Atherosclerotic cardiovascular disease (acute coronary syndrome, past myocardial infarction, angina, coronary or other arterial revascularization, past stroke, TIA, or peripheral artery disease) Primary elevations of LDL >190 mg/dL Diabetes age 40-75 Yo and LDL 70-189 Without clinical ASCVD or diabetes, age 40-75, LDL 70-189, and estimated 10-year ASCVD risk of 7.5% or higher Statin Intensity Criteria Individuals with clinical ASCVD Age <75: High-intensity Age >75: Moderate-intensity With primary elevations of LDL >190 mg/dL 40-75 Yo with diabetes and LDL 70-189 Estimated 10-y ASCVD risk >7.5%: High-intensity Estimated 10-y ASCVD risk < 7.5%: Moderate-intensity Without clinical ASCVD or diabetes, age 40-75, LDL 70-189 and estimated 10-year ASCVD risk of 7.5% or higher Moderate-to-high intensity Statin Intensity Moderate-intensity (30% to <50% LDL-C reduction) Atorvastatin 10-20 mg Rosuvastatin 5-10 mg Simvastatin 20-40 mg Pravastatin 40-80 mg Lovastatin 40 mg Fluvastatin 40 mg bid High-intensity (>50% LDL-C reduction) Atorvastatin 40-80 mg Rosuvastatin 20 mg Statin Side Effects Myalgia (muscle complaints without CK elevations) Myositis (muscle complaints with CK elevations) Rhabdomyolysis (elevated CK levels, elevated creatinine) Risk increased in liver or renal failure, hypothyroidism, diabetes mellitus Risk increased with macrolides, azoles, cyclosporine, gemfibrozil, niacin, HIV protease inhibitors, nefazodone, verapamil, diltiazem, and amiodarone. Risk increased with drinking more than a quart of grapefruit juice a day Routine monitoring of CK not required. Discontinue statin if CK more than 10 times upper limit of normal (ULN) Scroll Up error: Content is protected !!