Dan B. is a 48 year-old African American male who presented for a health maintenance exam. His BMI is 28.2, but he has no other comorbidities (negative for diabetes and smoking). Routine fasting lipid screening reveals TC of 234mg/di (high). His HDL-C is 32 (low), LDL is 144 (high) and TG are 134 (normal). Blood pressure is 146/84 and 2 previous BPs were 148/86 and 142/83. He is not currently on any medications. His 10 year risk of MI or CVA per American College of Cardiology calculation is 7.2% . The patient has a family history of premature ASCVD with father having MI at age 47 years. Best management for this patient is: O Counsel on lifestyle and recheck in 3 months Counsel on lifestyle and begin moderate intensity statin medication at this time; monitor BP as it is only mildly elevated • Counsel on lifestyle, start the patient on low dose thiazide and/or ace-inhibitor and begin risk discussion with the patient regarding starting a moderate intensity statin O Counsel on lifestyle and begin an ace-inhibitor to manage his blood pressure; his lipid levels do not require treatment at this time.
