Nevertheless, the decision to ini- tiate moderate- or high-intensity statin therapy in patients >75 years of age with ASCVD should be based on expected benefit versus competing 8. This recommendation is based on the observa- tion that the age reported in clinical trials of statin therapy in patients with ASCVD represents the patient s age at study entry. Therefore, it is rea- sonable to consider continuation of high-intensity therapy in patients >75 years of age with ASCVD if they are tolerating the statin and have a low risk of competing morbidities.S4.1-23,S4.1-26,S4.1-31 have not shown an adverse effect of statin therapy on cognition. 9. Although moderate-intensity statin therapy reduces ASCVD events, it is less effective than This difference pre- sumably is due to differences in LDL-C lowering potency. Hence, if ezetimibe were to be added to a moderate-intensity therapy to compensate for the difference in LDL-C lowering ability between moderate- and high-intensity statins, the combi- nation of moderate-intensity statin and ezetimibe could potentially produce a level of ASCVD risk reduction similar to that produced by high-inten- sity therapy alone. This hypothesis is supported by the finding that ezetimibe enhanced risk reduc- tion when combined with moderate-intensity therapy in patients after ACS.S4.1-15 Thus, it may be reasonable to add ezetimibe to moderate-inten- sity therapy in patients with ASCVD for whom high-intensity therapy is indicated but cannot be used, provided their LDL-C level remains 70 mg/ dL ( 1.8 mmol/L) on moderate-intensity therapy. The same reasoning holds for any patient whose LDL-C level remains 70 mg/dL ( 1.8 mmol/L) on maximally tolerated statin therapy 10. 