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Lipid modification - primary and secondary CVD prevention - Management
Which first-line lipid modification therapy should I offer for primary prevention of cardiovascular disease?
- Prescribe a statin, unless this is contraindicated (i.e. active hepatic disease, transaminase levels three or more times the upper limit of normal, unexplained persistent elevations of transaminases, pregnancy, and lactation).
- Simvastatin 40 mg daily is the first-line choice.
- Consider a lower dose of simvastatin or an alternative statin (e.g. pravastatin 40 mg daily) if there are potential drug interactions or simvastatin 40 mg is contraindicated (e.g. in people with renal impairment).
- Do not offer higher intensity statin therapy (e.g. simvastatin 80 mg daily), or a combination of a statin and other lipid-modifying treatment.
In depth
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