The Correct Answer is C!

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A 58-year-old Chinese-American presents for a routine evaluation. He has a family history of coronary disease. He is taking no medications, is a nonsmoker, and is mildly overweight. His blood pressure was 130/70 mm Hg, with a heart rate of 70 beats per minute. His lipid panel shows total cholesterol of 180 mg/dL and an HDL of 55 mg/dL. His 10-year ASCVD risk is 6.9% and his lifetime risk comes out at 36%. Based on his 10-year ASCVD risk, the ACC/AHA recommends a moderate-intensity statin. The U.S. Preventive Services Task Force would say that because he is not over 10% risk, he has no CVD risk factors and no statin therapy would be recommended. The patient is hesitant to start new medications, and notes in the ASCVD risk estimator app state that the score may overestimate patients of East Asian ancestry. The 2013 ACC/AHA risk assessment guidelines note that Asians may have lower ASCVD risk than Caucasians and African-Americans and since this factor is not included in the risk calculator, moderate-intensity statin therapy may be considered in this group of patients.

Which of the following has been shown to reduce CVD risk in a patient meeting this description?

  1. Neither statin nor ARB with diuretic
  2. ARB with a diuretic
  3. Statin
  4. Statin and an ARB with a diuretic

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