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Am Fam Physician. 2023;107(2):185-186

Related USPSTF Clinical Summary Statement: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Clinical Summary of the USPSTF Recommendation

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Case Study

R.B., a 66-year-old White woman, presents for a wellness visit. R.B. has no history of cardiovascular disease (CVD); she has a 35-pack-year smoking history and has consistently elevated systolic blood pressure measurements in the 142 to 148 mm Hg range, currently managed with lifestyle modifications. She does not take any medications. R.B.'s body mass index is 25 kg per m2, total cholesterol level is 180 mg per dL (4.66 mmol per L), and high-density lipoprotein cholesterol level is 50 mg per dL (1.29 mmol per L). Using the American College of Cardiology/American Heart Association Pooled Cohort Equations, you calculate R.B.'s estimated 10-year risk of an atherosclerotic CVD event to be 14.1%.

Case Study Questions

1. According to the U.S. Preventive Services Task Force (USPSTF) recommendation statement, is initiation of statin therapy for the primary prevention of CVD recommended for this patient?

  • A. Yes; R.B. has at least one cardiovascular risk factor, and her 10-year risk of a CVD event is more than 10%.

  • B. Yes; R.B. has no history of CVD, but she has at least one cardiovascular risk factor.

  • C. Maybe; R.B. has no history of CVD, but her 10-year risk of a CVD event is more than 10%.

  • D. No; R.B. has no history of CVD or a CVD event.

  • E. No; R.B. is older than 65 years.

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This series is coordinated by Joanna Drowos, DO, contributing editor.

A collection of Putting Prevention Into Practice published in AFP is available at

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