JL is right. From the NEJM:
Primary prevention:
Defined as patients with:
1. Diabetes mellitus (Type 1 or Type 2) requiring treatment with medication AND
2. Men and women ≥50 years of age AND
3. One ofthe following at Visit 1 (additional risk factor for CVD):
Men ≥55 years of age and Women ≥65 years of age;
Cigarette smoker or stopped smoking within 3 months before Visit 1;
Hypertension (blood pressure ≥140 mmHg systolic OR ≥90 mmHg diastolic) or on antihypertensive medication;
HDL-C ≤40 mg/dL for men or ≤50 mg/dL for women;
Hs-CRP >3.00 mg/L (0.3 mg/dL);
Renal dysfunction: Creatinine clearance (CrCL) >30 and <60 mL/min; Retinopathy, defined as any of the following: non-proliferative retinopathy, pre- proliferative retinopathy, proliferative retinopathy, maculopathy, advanced diabetic eye disease or a history of photocoagulation;
Micro- or macroalbuminuria. Microalbuminuria is defined as either a positive micral or other strip test (may be obtained from medical records), an albumin/creatinine ratio ≥2.5 mg/mmol or an albumin excretion rate on timed collection ≥20 mg/min all on at least two successive occasions; macroalbuminuria, defined as Albustix or other dipstick evidence of gross proteinuria, an albumin/creatinine ratio ≥25 mg/mmol or an albumin excretion rate on timed collection ≥200 mg/min all on at least two successive occasions;
ABI <0.9 without symptoms of intermittent claudication (patients with ABI <0.9 with symptoms of intermittent claudication are counted under Secondary Prevention Risk Category).
——————————
Secondary:
Defined as men and women ≥45 years of age with one or more of the following:
1. Documented coronary artery disease (CAD; one or more of the following primary criteriamust be satisfied):
• Documented multi vessel CAD (≥50% stenosis in at least two major epicardial
coronary arteries – with or without antecedent revascularization);
• Documented prior MI;
• Hospitalization for high-risk non-ST-segment elevation acute coronary syndrome(NSTE-ACS) (with objective evidence of ischemia: ST-segment deviation orbiomarker positivity).
2. Documented cerebrovascular or carotid disease (one of the following primary criteria must be satisfied):
• Documented prior ischemic stroke;
• Symptomatic carotid artery disease with ≥50% carotid arterial stenosis;
• Asymptomatic carotid artery disease with ≥70% carotid arterial stenosis per
angiography or duplex ultrasound;
• History of carotid revascularization (catheter-based or surgical).
3. Documented peripheral arterial disease (PAD; one or more of the following primary criteria must be satisfied):
• Ankle-brachial index (ABI) <0.9 with symptoms of intermittent claudication;
• History of aorto-iliac or peripheral arterial intervention (catheter-based or
surgical).
