If patient <40 years and has a predicted cardiovascular event rate of 30% or more over 10 years treat with simvastatin 40 mg daily.
There are no goals for treatment and no evidence to support uptitration.
If patients >= 40 years should be treated with a statin regardless of baseline total blood cholesterol concentration.
Recommended drug and dose is simvastatin 40mg daily.
If goals not achieved (i.e. total cholesterol concentration <5.0 mmol/l and a 25% reduction) then discuss medicine adherence.
Click here for cholesterol guideline.