Question of the Week

For June 30, 2015

A 56-year-old man with a history of stage 1 hypertension and obesity presents for follow-up related to his blood pressure and lipid levels. He currently takes no medications. He is 180 cm tall, weighs 107 kg, and has a BMI of 33. His blood pressure is 138/86 mm Hg. His father and one brother had myocardial infarctions at ages 51 and 52, respectively. During the past year, he has tried to adopt a low-fat diet and increase his exercise level, but he has had minimal success.

His fasting morning laboratory findings are as follows:

Patient value

Reference range

Glucose (mg/dL)

90

70–100

Glycated hemoglobin (%)

5.6

4.3–5.6

Total cholesterol (mg/dL)

213

LDL cholesterol (mg/dL)

126

HDL cholesterol (mg/dL)

35

Triglycerides (mg/dL)

260

The patient’s estimated 10-year risk for atherosclerotic cardiovascular disease is 9.0% according to the risk calculator of the American College of Cardiology and American Heart Association.

Which one of the following medications is most appropriate for this patient?

Gemfibrozil 600 mg twice daily
Lisinopril 10 mg
Fenofibrate 43 mg once daily
Metformin 500 mg twice daily
Simvastatin 40 mg once daily

Go to Top