Cardiovascular Risk And Prevention Practice Test

A 61-year-old postmenopausal woman with type 2 diabetes presents for follow-up. She is adherent to metformin; A1c is 6.6%. She is sedentary and has BMI 29 kg/m². BP is 130/78 mm Hg. Lipids: LDL 116 mg/dL, HDL 45 mg/dL, triglycerides 165 mg/dL. She is not on lipid-lowering therapy. Family history includes mother with MI at 55. She asks which medication adjustment most reduces cardiovascular risk.

Which medication adjustment is most indicated based on the patient's profile?

A 58-year-old postmenopausal woman with type 2 diabetes mellitus presents for routine care. She takes metformin 1000 mg twice daily and reports excellent adherence; home glucose logs are generally 90–130 mg/dL. She is sedentary due to an office job and knee discomfort, and she eats most meals from takeout. She does not smoke and drinks wine socially. BP is 136/82 mm Hg; BMI 29 kg/m². Recent labs: A1c 6.6%, total cholesterol 212 mg/dL, LDL 128 mg/dL, HDL 44 mg/dL, triglycerides 180 mg/dL, creatinine 0.9 mg/dL, urine albumin/creatinine ratio 18 mg/g. She is not taking a statin because she “feels fine.” Family history includes her mother having a fatal MI at age 54 and a maternal uncle with coronary bypass surgery in his 50s. She asks which medication change best lowers her risk of heart attack and stroke.

Which medication adjustment is most indicated based on the patient's profile?