Problem
Alan, a 47-year-old working Black male, is seen in your office for a follow-up for HLD. He had a lipid panel drawn 3 months ago that were elevated. At that time, you recommended that Alan try diet and exercise alone before starting a statin. Alan's blood pressure is 141/88 mm Hg on a medium-dose ACEI, his only medication. His BMI is 23.2. His father had a MI at age 72. He has never smoked. His lipid panel that was drawn yesterday is TC 240; Triglycerides 185; HDL-C 43; and LDL-C 162. What is the correct rationale and treatment for Alan?
1) Risk for a heart attack within 10 years is 10%; Prescribe Crestor 20mg daily.
2) Risk for a heart attack within 10 years is 10%; Continue with diet and exercise.
3) Risk for heart attack within 10 years is 10%; Prescribe Pravachol 40 mg.
4) Risk for a heart attack or stroke in his lifetime is 69%; Prescribe lovastatin 20 mg.