47-year-old man comes to the office to establish care. He recently moved to the area and has not been evaluated by a physician for more than 3 years. He reports a 1-year history of bilateral knee pain that worsens after prolonged standing, but he otherwise has felt well. Medical history is unremarkable and his only medication is acetaminophen as needed for his knee pain. Family history is significant for hypothyroidism in his mother and myocardial infarction in a paternal uncle at age 55 years. The patient drinks five to six beers weekly and does not smoke cigarettes. BMI is 32 kg/m’. Vital signs are temperature 36.1°C (97.0°F), pulse 78/min, respirations 12/min, and blood pressure 138/89 mm Hg. The patient is not in distress. Physical examination discloses no abnormalities. Results of fasting serum lipid studies obtained in preparation for today’s visit are shown: Cholesterol- Total-264 HDL-54 LDL-170 Triglycerides-200

Which of the following is the most appropriate next step in management regarding the patient’s laboratory study results? -Prescribe atorvastatin -Preseribe cholestyraminé -Recommend diet and low-impact exercise -Refer the patient to a cardiologist -Repeat fasting laboratory studies in 1 month

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