a) According to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) Guideline on the treatment of Blood Cholesterol in Adults, what are the main specified groups of patients who will have proven benefit from statin therapy? (4 marks)

b) Comment on whether lipid-lowering regimen is recommended for the case scenarios below based on the 2013 ACC/AHA guideline. If treatment is indicated suggest specific agent and dosage. 

i) A 64 year old male with past medical history of instable angina and hypertension. His LDL is 135 mg/dL (3.49 mmol/L) and HDL is 43 mg/dL (1.11 mmol/L). His blood pressure is 130/85mmHg, serum creatinine 2.26 mg/dL (200 umol/L) and is currently taking metoprolol 50 mg PO QD for his hypertension. (3 marks)

ii) A 45 year old Chinese female with past medical history of hypertension and heart failure New York Heart Association (NYHA) class III. Her LDL is 150 mg/dL (3.88 mmol/L) and HDL is 40 mg/dL (1.03 mmol/L). Her blood pressure is 130/85 mm Hg and is currently taking lisinopril 5 mg PO QD for her hypertension (4 marks)

iii) A 71 year old Chinese female with past medical history of diabetes mellitus. Her blood pressure is 130/85 mm Hg and her LDL level is 130 mg/dL (3.36 mol/L) and HDL is 35 mg/dL (0.91 mmol/L). (2 marks)

c) When should LDL level and liver function be monitored for patients newly started in statin therapy? What is the purpose of the monitoring? (2 marks)