American Board of Family Medicine (ABFM) Practice Exam

What is the recommended initial treatment for a patient with atherosclerotic cardiovascular disease (ASCVD) risk greater than 7.5%?

1. Low-intensity statin therapy

2. Moderate-or-high intensity statin therapy

3. Aspirin therapy alone

4. Fibrate medications

The correct answer is: Moderate-or-high intensity statin therapy

For a patient with atherosclerotic cardiovascular disease (ASCVD) risk greater than 7.5%, the recommended initial treatment is moderate- or high-intensity statin therapy. This recommendation is based on evidence that statins can significantly reduce the risk of cardiovascular events in individuals who have a higher estimated risk of heart disease. Moderate- or high-intensity statin therapy has been shown in clinical trials to lower LDL cholesterol levels effectively and reduce morbidity and mortality associated with cardiovascular diseases. The American College of Cardiology/American Heart Association guidelines suggest that individuals with a 10-year ASCVD risk of 20% or more, or those with clinically evident ASCVD, should receive high-intensity statins, while those with a 10-year risk of 7.5% to 19.9% should be considered for moderate-intensity statins. Other treatment options, such as aspirin therapy alone, are not sufficient as initial treatment in this context, as aspirin primarily addresses thrombotic events rather than lipid profiles. Low-intensity statin therapy may not provide the necessary LDL cholesterol reduction for patients in higher risk categories. Fibrate medications are generally not the first-line treatment for reducing cardiovascular risk and are typically used for specific conditions like