What is the appropriate management for a 40‑year‑old man with controlled hypertension on telmisartan 40 mg daily, non‑alcoholic fatty liver disease, and on pitavastatin 4 mg daily who has a very low‑density lipoprotein (VLDL) of 1.05 mmol/L, triglycerides of 2.29 mmol/L, alanine aminotransferase (ALT) of 107 U/L and aspartate aminotransferase (AST) of 58 U/L?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board

Educational purpose only • Exercise caution as content is pending human review

Article Review Status

Submitted

Under Review

Approved

Last updated: February 23, 2026 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Related Questions

How should I manage a 40‑year‑old man with well‑controlled hypertension on telmisartan 40 mg, non‑alcoholic fatty liver disease on pitavastatin 4 mg, who has a very low‑density lipoprotein of 1.05 mmol/L, triglycerides of 2.29 mmol/L, alanine aminotransferase of 107 U/L and aspartate aminotransferase of 58 U/L?

What is the best management approach for a 47-year-old female with fatty liver disease, elevated alanine transaminase (ALT) levels, hypertriglyceridemia (Trig 296), low high-density lipoprotein (HDL) cholesterol (30), elevated very-low-density lipoprotein (VLDL) cholesterol (59), and elevated low-density lipoprotein (LDL) cholesterol (102), with a 10-year atherosclerotic cardiovascular disease (ASCVD) risk of 4.4%?

What is the appropriate management for a patient with elevated liver enzymes and dyslipidemia?

What is the best course of treatment for an adult patient with elevated liver enzymes and dyslipidemia?

For a 30-year-old male with controlled hypertension on lisinopril, NAFLD, obesity, elevated LDL and hypertriglyceridemia, starting a moderate-intensity statin, when can statin therapy be stopped if desired and should metformin be initiated with an ALT of 5.8?

In a patient who had a hemorrhoidectomy three years ago and a low‑grade fistulotomy ten months ago and now has mild bladder hesitation and altered bladder sensation, does the hemorrhoidectomy cause persistent pelvic‑floor hypertonicity, and can ongoing pelvic‑floor physical therapy improve that tension and overall quality of life?

Should additional blood units be transfused when hemoglobin and hematocrit are normal after two units but the red blood cell count remains below the reference range?

In patients aged 65 years or older with type 2 diabetes mellitus, how common is the frailty phenotype and what are the recommended screening tools and management approaches to reduce disability, falls, hospitalization, and mortality?

How should I manage a 40‑year‑old man with well‑controlled hypertension on telmisartan 40 mg, non‑alcoholic fatty liver disease on pitavastatin 4 mg, who has a very low‑density lipoprotein of 1.05 mmol/L, triglycerides of 2.29 mmol/L, alanine aminotransferase of 107 U/L and aspartate aminotransferase of 58 U/L?

Ten months after a low transphincteric (intersphincteric) fistulotomy, could the procedure have damaged or entrapped nerves that control bladder sensation or urethral sphincter tone long‑term?

What is the recommended evaluation and management for an adult presenting with a new headache, including red‑flag assessment and pharmacologic treatment options?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.