Risk Status	LDL Goal	Level to Begin Lifestyle Change Therapies	Level to Consider Drug Therapy
CHD + CHD risk equivalentsa	< 100 mg/dl	>/= 100 mg/dl	>/= 100 mg/dlb
>/= 2 CHD risk factorsc
10-20% 10-yr risk	< 130 mg/dl	>/= 130 mg/dl	>/= 130 mg/dl
< 10% 10-yr risk	< 130 mg/dl	>/= 130 mg/dl	>/= 160 mg/dl
< 2 CHD risk factorsc	< 160 mg/dl	>/= 160 mg/dl	>/= 190 mg/dl

^aRisk equivalents are noncoronary atherosclerosis, diabetes, greater than 20% 10-year CHD risk.
^bIf the LDL level is above 130 mg/dl, drugs may be started simultaneously with diet therapy. If the level is 100-130 mg/dl, drug therapy may be considered, especially if lifestyle changes do not achieve the goal.
^cRisk factors are man over 45 years of age, woman over 55 years of age, family history of premature CHD, high blood pressure, HDL below 40 mg/dl, current cigarette smoking.

Risk Status	LDL Primary Goal	Non-HDL Secondary Goal
CHD or risk equivalenta	< 100 mg/dl	< 130 mg/dl
>/= 2 risk factorsb	< 130 mg/dl	< 160 mg/dl
< 2 risk factorsb	< 160 mg/dl	< 190 mg/dl

^aRisk equivalents are diabetes, metabolic syndrome, greater than 20% 10-year CHD risk.
^bRisk factors are man over 45 years of age, woman over 55 years of age, family history of premature CHD, high blood pressure, HDL below 40 mg/dl, current cigarette smoking.

Drug	Daily Dose (mg)	% Reduction
Atorvastatin	10	39
	20	43
	40	50
	80	60
Fluvastatin	20	22
	40	25
	80	36
Lovastatin	20	27
	40	32
	80	42
Pravastatin	10	22
	20	32
	40	34
Simvastatin	5	26
	10	30
	20	38
	40	41
	80	47

Data from Lipitor (atorvastatin) prescribing information, 2000 (Parke-Davis, Morris Plains, NJ; Pfizer Inc., New York, NY); Lescol (fluvastatin) prescribing information, 1999 (Novartis Pharmaceuticals Corp., East Hanover, NJ; Reliant Pharmaceuticals, Liberty Corner, NJ); Mevacor (lovastatin) prescribing information, 2000 (Merck & Co., Inc., West Point, PA); Zocor (simvastatin) prescribing information, 2000 (Merck & Co., Inc., West Point, PA); Pravachol (pravastatin) prescribing information, 2000 (Bristol-Myers Squibb Co., Princeton, NJ).

Drug	Dosage	LDL (%)	HDL (%)	TG (%)	Metabolism
Atorvastatin	80 mg/day	60	6	29	CYP3A4
Fluvastatin	40 mg/day	25	8	10	CYP2C9
Lovastatin	80 mg/day	42	8.6	16	CYP3A4
Pravastatin	40 mg/day	34	12	24	Sulfation
Simvastatin	80 mg/day	47	12	18	CYP3A4

TG = triglycerides.
Data from Lipitor (atorvastatin) prescribing information, 2000 (Parke-Davis, Morris Plains, NJ; Pfizer Inc., New York, NY); Lescol (fluvastatin) prescribing information, 1999 (Novartis Pharmaceuticals Corp., East Hanover, NJ; Reliant Pharmaceuticals, Liberty Corner, NJ); Mevacor (lovastatin) prescribing information, 2000 (Merck & Co., Inc., West Point, PA); Zocor (simvastatin) prescribing information, 2000 (Merck & Co., Inc., West Point, PA); Pravachol (pravastatin) prescribing information, 2000 (Bristol-Myers Squibb Co., Princeton, NJ).

Study	No. of Patients	Follow-up (yrs)	Drug	LDL/HDL Change (%)	Total Mortality (%)	CHD Death, Nonfatal MI (%)	PTCA, Bypass (%)
Primary prevention
LRC-CPPT[4]	3806	7.4	BAS	-13/2	-7	-19	NR
AFCAPS/TexCAPS[14]	6605	4.8	Lovastatin	-25/6	NR	-40	-33
WOSCOPS[13]	6595	4.9	Pravastatin	-26/5	-22	-31	-37
HHS[8]	4081	5	Gemfibrozil	-10/10	0	-34	NR
Secondary prevention
CDP[7]	1119	15	Niacin	-10/NA	-11	NR	NR
4S[12]	4444	5.4	Simvastatin	-35/8	-30	-34	-34
CARE[11]	4159	5	Pravastatin	-28/2	-9	-24	-27
LIPID[10]	9014	6	Pravastatin	-25/6	-22	-24	-20
PostCABG[16]	1351	4.3 + 3a	Lovastatin	-40/4	-35	-31	-30
VA-HIT[9]	2531	5.1	Gemfibrozil	0/6	-11	-22	-9
BIP[5]	3090	6.2	Bezafibrate	-7/18	+6	-11	-4
POSCH[6]	838	14.7	Surgery	-38/4	-25	-40	-69

LRC-CPPT = Lipid Research Clinics-Coronary Primary Prevention Trial; BAS = bile acid sequestrant; NR = not reported; AFCAPS/TexCAPS = Air Force/Texas Coronary Atherosclerosis Prevention Study; WOSCOPS = West of Scotland Coronary Prevention Study; HHS = Helsinki Heart Study; CDP = Coronary Drug Project; NA = not applicable; 4S = Scandinavian Simvastatin Survival Study; CARE = Cholesterol and Recurrent Events; LIPID = Long-Term Intervention with Pravastatin in Ischaemic Disease; PostCABG = Post Coronary Artery Bypass Graft Trial; VA-HIT = Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial; BIP = Bezafibrate Infarction Prevention Study; POSCH = Program on the Surgical Control of Hyperlipidemias.