Table 3.

High-, Moderate-, and Low-Intensity Statin Therapy^*

	High Intensity	Moderate Intensity	Low Intensity
LDL-C lowering†	≥50%	30%–49%	<30%
Statins	Atorvastatin (40 mg‡) 80 mg	Atorvastatin 10 mg (20 mg)	Simvastatin 10 mg
	Rosuvastatin 20 mg (40 mg)	Rosuvastatin (5 mg) 10 mg
		Simvastatin 20–40 mg§
	...	Pravastatin 40 mg (80 mg)	Pravastatin 10–20 mg
		Lovastatin 40 mg (80 mg)	Lovastatin 20 mg
		Fluvastatin XL 80 mg	Fluvastatin 20–40 mg
		Fluvastatin 40 mg BID
		Pitavastatin 1–4 mg

Percent LDL-C reductions with the primary statin medications used in clinical practice (atorvastatin, rosuvastatin, simvastatin) were estimated using the median reduction in LDL-C from the VOYAGER database.^S3.1.1-2 Reductions in LDL-C for other statin medications (fluvastatin, lovastatin, pitavastatin, pravastatin) were identified according to FDA-approved product labeling in adults with hyperlipidemia, primary hypercholesterolemia, and mixeddyslipidemia.^S3.1.1-6 Boldface type indicates specific statins and doses that were evaluated in RCTs, ^{S3.1.1-7–S3.1.1-19} and the Cholesterol Treatment Trialists’ 2010 meta-analysis.^S3.1.1-20 All these RCTs demonstrated a reduction in major cardiovascular events.

^*Percent reductions are estimates from data across large populations. Individual responses to statin therapy varied in the RCTs and should be expected to vary in clinical practice.^S3.1.1-2

^†LDL-C lowering that should occur with the dosage listed below eachintensity.

^‡Evidence from 1 RCT only: down titration if unable to tolerate atorvastatin 80 mg in the IDEAL (Incremental Decrease through Aggressive Lipid Lowering) study.^S3.1.1-18

^§Although simvastatin 80 mg was evaluated in RCTs, initiation of simvastatin 80 mg or titration to 80 mg is not recommended by the FDA because of the increased risk of myopathy, including rhabdomyolysis.

BID indicates twice daily; FDA, US Food and Drug Administration; LDL-C, low-density lipoprotein cholesterol; RCT, randomized controlled trial; VOYAGER, an individual patient data meta-analysis Of statin therapy in Atrisk Groups: Effects of Rosuvastatin, atorvastatin and simvastatin; and XL, extended release.