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Primary prevention lipid therapy — GPhC CRA MCQ

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HardCardiovascular TherapeuticsPrimary prevention lipid therapyGPhC CRA

A 62-year-old without CVD has QRISK3 14%. ALT is 82 IU/L (laboratory upper limit 40), CK is normal and there are no muscle symptoms. What is the most appropriate lipid recommendation?

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Correct answer: B — Offer atorvastatin 20 mg after discussion with guideline-based liver monitoring

QRISK3 at least 10% supports atorvastatin 20 mg for primary prevention after an informed discussion. NICE says transaminases below three times the upper limit should not routinely exclude statin treatment; this ALT is just over twice the limit. Atorvastatin 80 mg is not the routine primary-prevention starting dose, and ezetimibe is not first line solely for this result.

Reference: NICE NG238: https://www.nice.org.uk/guidance/ng238/chapter/recommendations