The Framingham Risk Score is used to estimate 10-year cardiovascular risk. A patient with a calculated 10-year CVD risk of 12% falls into which risk category, and what is the recommended primary prevention intervention threshold for statin therapy?

• A Low risk (<10%); no statin therapy indicated
• B High risk (>10%); statin therapy recommended regardless of LDL-C level
• C Intermediate risk; statin therapy recommended if LDL-C ≥ 190 mg/dL
• D Intermediate risk (7.5%–20%); consider statin if LDL-C ≥ 70 mg/dL after lifestyle modification ✓

Explanation

Per ACC/AHA 2019 guidelines (referenced in Park's for NCD control), 10-year ASCVD risk of 7.5–20% defines intermediate risk. In this group, statin initiation in primary prevention is guided by risk enhancers and a risk discussion — not automatic. The threshold for statin consideration in intermediate risk is LDL-C ≥ 70 mg/dL after lifestyle optimisation, particularly if additional risk enhancers (e.g., hs-CRP ≥2, coronary calcium score ≥100) are present. High risk (≥20%) warrants high-intensity statin therapy.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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