PAINE PANCE Pearl – Endocrine

What are the indications for high-intensity statin therapy for hyperlipidemia?

New joint guidelines were released in 2013 by ACC/AHA on the management of hyperlipidemia.  In these guidelines, there are 3 criteria for high intensity statin therapy:

  1. Age < 75 years with a clinical Atherosclerotic Cardiovascular Disease (ASCVD):
    1. Acute coronary syndrome
    2. Myocardial infarction
    3. Stable or unstable angina
    4. Revascularization procedures
    5. Cerebrovascular disease
    6. Peripheral arterial disease
  2. LDL ≥ 190 mg/dL
  3. Age 40-75 years, with diabetes, LDL 70-189 mg/dL, and 10-year ASCVD risk > 7.5%

2013 ACC/AHA Hyperlipidemia Guidelines

What are the drugs and dosing for high-intensity statin therapy?

There are only 2 medications that have been studied that are recommended for high-intensity statin therapy:

  1. Atorvastatin 40-80mg daily
  2. Rosuvastatin 20-40mg daily

2013 ACC/AHA Hyperlipidemia Guidelines




  1. Stone NJ, Robinson JG, Lichtenstein AH. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. 63(25 Pt B):2889-934. 2014. [pubmed]

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