A 66-year-old retired nurse practitioner, treated for essential hypertension and dyslipidemia, discontinued statins 1 year ago because of concerns regarding their possible adverse effects on the liver. On her annual physical examination, the blood pressure was 135/80 mm Hg in the right and left arms, weight 135 lb (60.75 kg) and height 5 ft 7 in (1 m 70 cm). A grade 2/6 systolic murmur was heard over the aortic area (second right costal interspace) consistent with a diagnosis of aortic valve sclerosis without evidence of stenosis, confirmed on echocardiography. The level of total cholesterol was 270 mg/dL (6.98 mmol/L); high-density lipoprotein cholesterol, 45 mg/dL (1.16 mmol/L); low-density lipoprotein cholesterol, 168 mg/dL (4.34 mmol/L); and triglyceride, 152 mg/dL (1.72 mmol/L). She was on a salt-poor diet, a daily diuretic combination (tri-amterene 37.5 mg, hydrochlorothiazide 25 mg), and metoprolol 150...

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