Do you recommend starting a statin in patients above 75 years old with diabetes but no known ASCVD?  

Taking into consideration a patient’s comorbid conditions, functional status, polypharmacy, and overall quality of life, I may counsel for starting a statin in a patient in her 70s with diabetes.

The time to benefit (TTB) for statins in primary prevention of cardiovascular events is generally about 1.5 to 3 years. This means that adults aged 50 to 75 years typically need to take statins for at least 2.5 years to achieve a meaningful reduction in major adverse cardiovascular events (MACE), su...

This is a good place to practice using the 4Ms and "What Matters Most." The ASCVD risk evaluation generally gives us a 10-year risk prognosis, even if we can't use it past age 75. But we can use that as a framework. If this is a patient in their late 70s with well-controlled diabetes, with limited ...