University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Vascular Surgery


Elyse Watkins, DHSc, PA-C, DFAAPA



Purpose: The purpose of this article is to establish guidelines for primary care providers in prescribing and monitoring statin medications.

Method: A literature review was conducted using Pubmed and Google Scholar with search terms statins, atherosclerotic disease, statin guidelines, high dose statin. Articles were chosen based on validity and relevance. Recent articles, those less than 5 years old were used when possible.

Results: There is sufficient evidence to show that statins can decrease morbidity and mortality associated with cardiovascular disease, loss of limbs and strokes.1 The risk of hepatotoxicity needs to be weighed against the benefit for individual patients, given their disease state and tolerance. Cardiovascular patients on high dose statin therapy had fewer all-cause mortality than similar patients on moderate or low dose statins.2 Patients should be prescribed statins based on their cardiovascular risk and tolerance.

Conclusion: Primary care providers should be more aggressive in ordering statin medications for adult patients to reduce long term risk of myocardial infarction, stroke and amputation. Additionally, these patients need blood test monitoring of liver function, especially in the first six months of starting a medication. This is especially important in patients who are high risk from other chronic conditions such as diabetes and hypertension, those with significant family history of CAD and those who have already had an atherosclerotic related event.


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