For a 51-year-old man with multiple cardiovascular risk factors and an ASCVD score of 23%, which statin is recommended?

In this scenario, a 51-year-old man with multiple cardiovascular risk factors and an ASCVD (Atherosclerotic Cardiovascular Disease) risk score of 23% indicates a high risk for cardiovascular events. In such cases, the goal is to initiate intensive statin therapy to significantly lower low-density lipoprotein cholesterol (LDL-C) levels and reduce the overall risk of cardiovascular events.

Atorvastatin 80 mg daily is recommended as it represents a high-intensity statin therapy. High-intensity statins can lead to a decrease in LDL-C levels by 50% or more, which is crucial for high-risk patients like this individual. This level of intensity is supported by guidelines that suggest those with high ASCVD risk should be treated with high-intensity statin therapy to achieve maximum benefit in reducing cardiovascular events.

Other options represent lower-intensity therapies. While pravastatin, rosuvastatin at a lower dose, and lovastatin can be effective in lowering LDL-C, they do not match the potency of atorvastatin at the 80 mg dosage. Therefore, they would not provide the same level of risk reduction in this high-risk patient. In summary, atorvastatin at a high dose is the most appropriate