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April 2023

Important Cholesterol Management Update

Written by Lee Davis, RPh

Important changes in blood cholesterol management have been put into place recently. Statin drug therapy is still the mainstay of treatment, however, the threshold at which to begin statin therapy has been lowered. Familiar medications such as Rosuvastatin (Crestor), Atorvastatin (Lipitor), Pravastatin (Pravachol), Simvastatin (Zocor), and other statins have been around for years. These medications have proven to have beneficial effects in reducing the bad cholesterol, known as LDL-C, and thus reducing the threat of cardiovascular disease including heart attack and stroke. The new change in the management of LDL-C is a lower threshold at which to begin statin therapy for certain patient groups.
In the past, the rule of thumb to begin statin therapy was an LDL-C greater than 100mg/dl. This is still the case when there are primary risk factors only, such as high blood pressure or a history of cardiovascular disease. However, according to the American College of Cardiology and the American Heart Association when there are secondary risk factors involved as well, then a tighter LDL-C control is required. When secondary risk factors are present along with primary risk factors, the new threshold to begin statin therapy is an LDL-C of 70mg/dl and above. Secondary risk factors include age (40-75), diabetes, and nicotine status.
An ASCVD (AtheroSclerotic CardioVascular Disease) Risk Calculator is available online to predict the potential 10-year risk of a major ASCVD event. After entering the required information, If the ASCVD Risk Calculator gives a value between 7.5% to 20% then you fall into the new treatment category of LDL-C of 70mg/dl. The web address for the Risk Calculator is Blood pressure and cholesterol measurements will be needed as part of the calculations.
Statin drugs have received a bad reputation over the years due to troublesome side effects, as well as perceived ineffectiveness. Research has shown that approximately 50% of statin prescriptions have either not been filled or were discontinued within the first six months of therapy. The staff at Specialty Pharmacy Services hope to reverse this trend. We want to bring the importance of statin therapy to the forefront in the fight against heart disease. Please reach out with questions using the Risk Calculator tool, minimizing statin drug side effects, or questions you should discuss with your physician.
Simplify your Meds. Simplify your Life. Make an appointment today and let us discuss your medication profile. Call us at (850)226-8162 or email You can also visit us on the web at for more information. Our office is conveniently located at 533 Eglin Parkway NE, Fort Walton Beach, in Paradise Plaza next to Denny’s.

Khera,A., (2019), The New 2018 Cholesterol Guidelines, Circulation Journal.
Grundy,S.M., et al, (2019), 2018 AHA/ACC/MultiSociety Guideline on Management of Blood Cholesterol, Circulation Journal.

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