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Interpreting cholesterol "average risk"


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New FP PA here curious how others are using the "average risk" comparison in managing lipids. 

 

My lab breaks down the XOL/HDL ratio to: 1/2 the average risk, average risk, 2x average, and 3x average.

 

For example, take this diabetic pt with a Total XOL of 263 and HDL of 90. He is well under 1/2 the average risk with a ratio of 2.9.However, he is still a diabetic and LDL is 170 on a low dose statin...

 

 

 

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[...] my philosophy is to be fairly liberal with statins.  They are safe, cheap, and effective with few adverse effects.

And Atorvastatin (Lipitor) is generic now, and Rosuvastatin (Crestor) runs out next year, so expect to just continue to see more and better options, cheaper.

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lipid panel like that in a diabetic - unless they are 100 years old, and have amazing BS control (with an A1C of <7) I would treat with a statin.

 

I still think as DM as "close to" a risk equivalent to prior CAD - Yup I know I am out of step with the current guidelines, but this is my interpretation of what is best for the patient..... 

before you flame me.... remember Vioxx and HRT for hot flashes.... for years we thought that was good.... I believe that hyperglycemia with long term DMII with a less then stellar cholesterol panel should be treated with a statin

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