High-intensity statin* + lifestyle [B]

If not high-intensity statin candidate, use mod-intensity tx. Other FDA-approved options not included in RCTs: rosuvastatin 40 mg. Atorvastatin 40 mg: evidence from 1 RCT only after down-titration from 80 mg due to intolerance. It is reasonable to intensify statin tx to achieve at least a 50% LDL-C reduction [E]. After max statin intensity achieved, it is reasonable to add a nonstatin drug to further reduce LDL-C [E].