Question

A 52-year-old man with type 2 diabetes (diagnosed 5 years ago) and hypertension attends for cardiovascular risk assessment. He is a non-smoker with a BMI of 30 kg/m². His latest results: LDL cholesterol 3.6 mmol/L, HDL 0.9 mmol/L, triglycerides 2.0 mmol/L, blood pressure 138/84 mmHg on ramipril and metformin. He has no clinical cardiovascular disease. What is the most appropriate lipid management strategy according to Australian guidelines?

Accepted Answer

Commence a moderate- to high-intensity statin regardless of calculated absolute risk

Answer

Reassure him that no lipid-lowering therapy is required because his LDL is below 4.0 mmol/L

Answer

Start low-dose simvastatin 10 mg daily only if his 5-year CVD risk exceeds 15%

Answer

Use fish oil supplements as first-line therapy instead of statins

Answer

Switch ramipril to a beta blocker to improve his lipid profile

Practice question