Question

A 54-year-old man with no known cardiovascular disease presents for a health check. He is a non-smoker with no history of diabetes or hypertension. His BMI is 27 kg/m². Fasting lipids show total cholesterol 7.0 mmol/L, LDL-C 5.3 mmol/L, HDL-C 1.2 mmol/L and triglycerides 1.4 mmol/L. His calculated 10-year Framingham risk is 12%. According to the 2021 Canadian Cardiovascular Society dyslipidaemia guidelines, what is the most appropriate management of his lipid profile?

Accepted Answer

Start a high-intensity statin because his LDL-C is >=5.0 mmol/L, regardless of calculated risk.

Answer

Reassure him that his risk is low and repeat lipid testing in five years.

Answer

Recommend lifestyle modification only; pharmacological therapy is not indicated because his Framingham risk is <20%.

Answer

Order a coronary CT angiogram to further risk stratify before deciding on treatment.

Answer

Start low-dose aspirin without statin therapy for primary prevention.

Practice question