Aggressive treatment may not be necessary for older individuals (e.g., 70-year-olds) with hyperlipidemia but a clean CTA if protective factors are present and the patient does not desire it.

“even if you put aside the false positives or the false negatives rather to your point the physiology of the disease tells us that's the wrong metric to care about it's more interesting I suppose when you have perfectly clean ctas in 70 year olds with hyperlipidemia to which you can say well look clearly this person has other factors that are protective we might not understand what they are and this is a patient in whom aggressive treatment probably isn't necessary especially if they don't feel if the patient themselves doesn't want it”