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Lipid Management in Post-Menopausal Patient

History of Present Illness 

Patient is a 58-year-old female, 61 inches tall, 228 lbs., with history of obesity, high cholesterol, and hypothyroidism. Patient presents with complaints of fatigue, mild chest pain, and general complaint of “I just don't feel good.” She has not received medical care for two years. 

Medical History 

Patient is non-compliant with instructions to lose weight. She is post-menopausal, having entered menopause at age 41. She reports that her PCP stated that she "don’t need cholesterol medicine,” because although her LDL was 161, HDL was 59. She complies with taking thyroid medication. 

Social History 

Patient lives alone, and engages in little activity. 

Questions 

1. Why do you need to pay attention to cardiovascular risk with this patient? 
2. Do you agree with the PCP’s decision not to prescribe a statin?