What is the primary focus when starting statin therapy?

The primary focus when starting statin therapy is risk-based decision making. This approach considers a patient's overall cardiovascular risk profile, which includes factors such as age, sex, cholesterol levels, blood pressure, smoking status, diabetes, and family history of cardiovascular disease. Statin therapy is often initiated in individuals who are at high risk for cardiovascular events, based on these risk factors, rather than solely on cholesterol levels.

Risk-based decision making emphasizes the importance of individualizing treatment plans to optimize patient outcomes and prevent cardiovascular morbidity and mortality. Statins have been shown to benefit a wider range of patients beyond those with high cholesterol; therefore, the strategy focuses on those most likely to benefit from therapy given their overall risk of cardiovascular disease.

In contrast, simply managing blood pressure or addressing cholesterol levels without lifestyle changes does not provide a comprehensive approach to cardiovascular risk management. Immediate reduction of triglycerides, while important, is not the singular focus for initiating statin therapy and is typically considered in breadth alongside other lipid markers and overall risk.