According to USPSTF statin recommendations, what is the guidance for ASCVD risk between 7.5% and 10%?

• A. Start statin
• B. Shared decision making (discuss with patient)
• C. No recommendation of discussion
• D. Do not start medication

Answer: (B)

When the 10-year ASCVD risk falls between about 7.5% and 10%, the guidance is to engage in shared decision making with the patient regarding statin therapy. This means the clinician and patient discuss the potential benefits (reduced risk of heart attack and stroke) and possible harms (muscle symptoms, small risk of diabetes, liver issues, cost, pill burden) and tailor the decision to the patient's values, preferences, and specific risk profile. Because the absolute benefit is modest and varies by individual factors, there isn’t a one-size-fits-all mandate to start a statin. If, after discussion, the patient prefers to proceed, statin therapy can be started; if not, it can be deferred.