What Is This Older Man’s LDL-C Goal?

Welcome to our latest series on lipid management. Part 1 of 5 highlights a clinical vignette of a 68-year-old man seeking advice about prediabetes. Read the case, and take our short quiz. Then, listen to the podcast with Paul Jellinger, MD, MACE, to see if you are correct!

A 68-year-old man seeks your advice for evaluation of “prediabetes.” He has had persistent fasting plasma glucose levels between 105 and 115 mg/dL for many years and a recent hemoglobin A1C concentration of 6.1%. He has been treated for hypertension for more than 10 years. At age 62, he experienced a left-sided transient ischemic attack. He has no personal history of coronary artery disease and no family history of premature atherosclerotic cardiovascular disease. He feels well.

His current medications are ramipril, 10 mg daily; aspirin, 162 mg daily; and atorvastatin, 40 mg daily.

He is obese, with a body mass index of 33 kg/m2. His blood pressure is 134/76 mm Hg. Physical examination findings are unremarkable except for 2+ peripheral pulses, absent deep-tendon reflexes, and mildly diminished peripheral vibratory sensation. There is a questionable right-sided carotid bruit.

Laboratory test results were as follows: fasting plasma glucose, 112 mg/dL; hemoglobin A1c, 6.1%; serum creatinine, 1.5 mg/dL; estimated glomerular filtration rate, 45 mL/min/1.73 m2; total cholesterol, 148 mg/dL; high-density lipoprotein cholesterol (HDL-C), 40 mg/dL; triglycerides, 165 mg/dL; low-density lipoprotein cholesterol (LDL-C), 78 mg/dL; high-sensitivity C-reactive protein, 1.6 mg/L.

For a hint, click here.

Be sure to tune into the podcast with Dr Paul Jellinger for the answer and background!