What is the most appropriate moderate-intensity statin treatment for a 67-year-old man with hypertension currently on diltiazem and HCTZ?

Pravastatin is considered the most appropriate moderate-intensity statin treatment for this scenario due to several factors. First, it has a well-established safety profile, particularly in older adults and those with multiple comorbidities, which is relevant for a 67-year-old man.

Pravastatin is also less likely to interact with diltiazem, a calcium channel blocker the patient is currently prescribed, reducing concerns about potential drug interactions that could enhance side effects or diminish therapeutic efficacy.

Furthermore, moderate-intensity statins like pravastatin effectively lower LDL cholesterol levels, which is essential for managing cardiovascular risk, especially in patients with hypertension. This aligns with guidelines that recommend statin therapy in older adults, particularly in the presence of hypertension, to prevent cardiovascular events.

While lovastatin, simvastatin, and atorvastatin are also effective statins, they may have different interaction profiles with the patient's current medications. For example, both simvastatin and atorvastatin have a higher potential for drug-drug interactions with diltiazem compared to pravastatin. Thus, pravastatin emerges as the optimal choice in this clinical context.