Which of the following adjustments should be recommended to improve a patient's cardiovascular risk who is already on atorvastatin and other therapies?

The recommendation to increase atorvastatin to 80 mg daily and add lisinopril 5 mg daily is advantageous for improving a patient’s cardiovascular risk. Atorvastatin, as a high-intensity statin, is effective in lowering LDL cholesterol and significantly reducing the risk of cardiovascular events. The 80 mg dose has been shown to be effective for patients who need further LDL reduction beyond the 40 mg daily dose, especially in those at high cardiovascular risk.

Adding lisinopril, an ACE inhibitor, provides additional benefits. ACE inhibitors are known to improve cardiovascular outcomes, particularly in patients with hypertension, heart failure, or a history of myocardial infarction. They help in remodeling the heart and reducing blood pressure, consequently lowering cardiovascular risk further.

The combination of optimizing atorvastatin’s dosage with the addition of an ACE inhibitor like lisinopril offers a synergistic approach to risk reduction by targeting both lipid levels and blood pressure management.

This strategy stands out as the most comprehensive option focused on enhancing the overall cardiovascular profile of the patient, taking into account both lipid management and blood pressure control.