. Author manuscript; available in PMC: 2013 Dec 14.

Published in final edited form as: Arch Intern Med. 2010 Mar 8;170(5):10.1001/archinternmed.2009.525. doi: 10.1001/archinternmed.2009.525

Table 5.

Physicians’ Threshold for Prescribing Cholesterol-Lowering Therapy Based on Patients’ Risk Factors Alone, and with the addition of 10-year Risk and Lifetime Risk

Case (number of responses analyzed)	Guideline recommendation^1,4		Information Provided to Physician
		LDL threshold for Prescribing Cholesterol- Lowering Medication	Risk factors only	Risk factors and 10-year coronary risk	P value vs. RF only	Risk factors, 10-year coronary risk, and lifetime coronary risk	P value vs. RF only	P value vs. RF and 10- year risk
		Physicians’ LDL thresholds for prescribing a statin, %
1. Male, 10-year risk 4%, lifetime risk 43%, LDL-C (135 mg/dl) is below threshold for drug therapy (94)	Consider drug therapy for LDL ≥160 mg/dl after TLC				NS		0.02	0.003
	Consider drug therapy for LDL ≥160 mg/dl after TLC	Guideline concordant	44	44		34
		Guideline discordant
		Higher than guideline	26	26		22
		Lower than guideline	30	30		44
2. Male, 10-year risk 15%, lifetime risk 47%, LDL-C (135 mg/dl) is above goal (93)	Consider drug therapy for LDL ≥130 mg/dl after TLC	Guideline concordant			0.05		0.005	NS
	Consider drug therapy for LDL ≥130 mg/dl after TLC	Same as guideline	39	38		34
	Optional ≥100 mg/dl after or concurrently with TLC	Same as optional	29	39		44
	Optional ≥100 mg/dl after or concurrently with TLC	Guideline discordant
		Higher than guideline	2 3	22		21
		Lower than guideline	0	1		1
3. Female, 10-year risk 2%, lifetime risk 11%, LDL-C (158 mg/dl) is at goal (93)	Consider drug therapy for LDL ≥190 mg/dl after TLC	Guideline concordant			NS		NS	NS
	Consider drug therapy for LDL ≥190 mg/dl after TLC	Same as guideline	27	31		31
	Optional ≥160 mg/dl after TLC	Same as optional	42	40		36
		Higher than guideline	4	4		4
		Lower than guideline	27	25		29
4. Female, 10-year risk 3%, lifetime risk 26%, LDL-C (158 mg/dl) is at goal (92)	Consider drug therapy for LDL ≥190 mg/dl after TLC	Guideline concordant			NS		NS	NS
	Consider drug therapy for LDL ≥190 mg/dl after TLC	Same as guideline	12	12		11
	Optional ≥160 mg/dl after TLC	Same as optional	36	40		32
	Optional ≥160 mg/dl after TLC	Guideline discordant
		Higher than guideline	6	8		6
		Lower than guideline	46	40		51
5. Male, 10-year risk 2%, lifetime risk 37%, LDL-C (132 mg/dl) is at goal (90)	Consider drug therapy for LDL ≥190 mg/dl after TLC	Guideline concordant			NS		NS	NS
	Consider drug therapy for LDL ≥190 mg/dl after TLC	Same as guideline	38	39		37
	Optional ≥160 mg/dl after TLC	Same as optional	37	38		35
	Optional ≥160 mg/dl after TLC	Guideline discordant
		Higher than guideline	10	8		7
		Lower than guideline	15	15		21

LDL-C = low-density lipoprotein cholesterol, RF = Risk Factors, TLC = Therapeutic Lifestyle Change, NS = Not Significant