A 35-Year-Old Man With a History of Premature Coronary Disease

Editor's Note: Based on the 2013 Blood Cholesterol, Lifestyle Management, Obesity, and Risk Assessment Guidelines.

A 35-year-old man has a strong family history of premature coronary disease, with both father and brother having an MI before age 55. He is a nonsmoker, nondiabetic and exercises for 150 minutes/week. He has gained 10 lbs since age 18. His BP is 140/90 mm Hg, weight is 170 pounds, height is 70 inches, and BMI is 24.4. On a fasting lipid panel, his LDL–C is 160 mg/dL, HDL–C 45 mg/dL and triglyceride 100 mg/dL. His fasting blood glucose is 92 mg/dL. He is on a heart-healthy diet and exercises 150 minutes a week. He and his wife would like to discuss statin therapy given his strong family history.

Which of the following is likely to be helpful in making a decision regarding statin therapy in this patient?

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