Statin Intensity and Benefit Groups

The 2013 ACC/AHA Cholesterol Guidelines stated the different statin intensities, four statin benefit groups and which statin dose each group would benefit the most from.

Low-Intensity Statins	Moderate-Intensity Statins	High-Intensity Statins
daily dose lowers LDL by < 30%	lowers LDL by 30 – 50%	lowers LDL by ≥ 50%
Pravastatin 10 – 20 mg Lovastatin 20 mg Simvastatin 10 mg Fluvastatin 20 – 40 mg Pitavastatin 1 mg	Simvastatin 20 – 40 mg Lovastatin 40 mg Atorvastatin 10 (20) mg Rosuvastatin 10 (5) mg Pravastatin 40 (80) mg Fluvastatin 40 mg BID Pitavastatin 2 – 4 mg	Atorvastatin 40 – 80 mg Rosuvastatin 20 (40) mg
Bold = evaluated in RCT, Italics = FDA approved doses but not studied

Four Statin Benefit Groups:

1. Individuals with clinical ASCVD

    - Clinical ASCVD = acute coronary syndromes or history of MI, TIA, stroke, angina, coronary or other arterial revascularization, or peripheral arterial disease 

2. Individuals with primary elevations of LDL ≥190 mg/dL

3. Individuals 40 to 75 years of age with diabetes and LDL 70 to 189 mg/dL without clinical ASCVD

4. Individuals without clinical ASCVD or diabetes who are 40 to 75 years of age and have LDL 70 to 189 mg/dL and an estimated 10-year ASCVD risk of ≥7.5%. This requires a clinician-patient discussion.

Stone NJ, et al. 2013 ACC/AHA Blood Cholesterol Guideline. Circulation. Published online 12 Nov 2013.