The 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol identifies four major statin benefit groups. One of these groups comprises adults aged 21 years and older with primary, severe elevations of low-density lipoprotein cholesterol (LDL-C) at a concentration of 190 mg/dL or greater. For this group, the guideline recommends initiating high-intensity statin therapy to achieve at least a 50% reduction in LDL-C, as this level of hypercholesterolemia confers a high lifetime risk for atherosclerotic cardiovascular disease (ASCVD).

A. ≥ 100 mg/dL: This was a treatment target in older guidelines (ATP III) but is not the 2013 threshold for initiating high-intensity statin therapy based on LDL-C alone.

B. ≥ 130 mg/dL: This was another treatment target in older guidelines, not the specific threshold for this indication in the 2013 guideline.

D. ≥ 200 mg/dL: This value is incorrect; the guideline specifically defines the threshold for severe hypercholesterolemia as ≥190 mg/dL.

E. ≥ 150 mg/dL: This value is incorrect and does not represent a specific threshold for high-intensity statin initiation in the 2013 guideline.

1. Stone

N. J.

Robinson

J. G.

Lichtenstein

A. H.

Bairey Merz

C. N.

Blum

C. B.

Eckel

R. H.

... & Wilson

P. W. (2014). 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation

129(25suppl2)

S1-S45. https://doi.org/10.1161/01.cir.0000437738.63853.7a (See Table 3: "The 4 Statin Benefit Groups

" page S15

and Recommendation #3

page S18).