A 50-year-old Caucasian man with a past medical history significant for rheumatoid arthritis (RA) and hypertension presents to his primary care physician’s office for his yearly physical. He has a 10-year history of hypertension and is on lisinopril 10 mg daily. He has a 15-year history of seropositive RA with erosive changes on radiographs. He is taking methotrexate 20 mg weekly along with folic acid 1 mg daily with good control of his arthritic symptoms. On his most recent rheumatology visit, he was noted to have a clinical disease activity index (CDAI) of 6, suggestive of low disease activity.
On physical examination, his vital signs are: heart rate, 74 beats/min; blood pressure, 120/80 mm Hg; respiratory rate, 16 breaths/min. He is afebrile. Body mass index (BMI) is 25.6 kg/m2.
The results of the patient’s most recent lipid panel are: total cholesterol (TC), 150 mg/dL (reference, < 200); high-density lipoprotein (HDL) cholesterol, 45 mg/dL (reference, > 40); low-density lipoprotein (LDL) cholesterol, 100 mg/dL (reference, 100); triglycerides 130 mg/dL (reference, 150).
He does not have a history of diabetes and is a lifetime nonsmoker. His 10-year atherosclerotic cardiovascular disease (CVD) risk score is 3.1%.