Cardiovascular Risk Reduction in a Patient with Diabetes with Risk Factors

A 52-year-old Caucasian woman presents to your clinic for follow-up.

Past medical history: Hyperlipidemia (10 years), hypertension (10 years), type 2 diabetes (5 years).

Family history: Father – diabetes and hypertension; died after myocardial infarction (MI) at age 55 years; Mother – currently 72 years of age; hypertension, hyperlipidemia, and osteoporosis.

Medications: Amlodipine 10 mg PO daily, aspirin 81mg PO daily, atorvastatin 80mg PO daily, lisinopril 40mg PO daily, metformin 1 gram PO twice daily.

Allergies: None

Social history: Denies alcohol and tobacco use.

Vitals: Blood pressure: 128/78 mm Hg, heart rate: 82 beats per min, weight: 180 lbs, BMI: 28.2 kg/m2.

Labs: Total cholesterol 185 mg/dL, triglyceride 250 mg/dL, HDL-C 45 mg/dL, LDL-C 90 mg/dL, non-HDL-C = 140 mg/dL, fasting glucose 110 mg/dL, A1c 6.8%

The patient states adherence with healthy lifestyle and medications. During the clinician-patient discussion, she states that she is willing to take additional medications with proven cardiovascular risk reduction benefits.

Which of the following medications may be considered at this time for this patient?

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