Conditions
Dyslipidemia
Risk assessment, baseline labs, and lipid-lowering priorities.
Last reviewed 2026-01-05|cardio | metabolic | lipids
Diagnosis
- Obtain a non-fasting or fasting lipid panel and calculate cardiovascular risk.
- Identify secondary contributors (hypothyroidism, nephrotic syndrome, medications).
Initial workup
- Baseline A1C, TSH if indicated, liver enzymes before starting statin therapy.
- Document family history and physical findings suggesting familial dyslipidemia.
First-line management
- Lifestyle: heart-healthy diet, physical activity, weight management, and smoking cessation.
- Start statin therapy for high-risk groups and moderate/high calculated risk.
- Add ezetimibe or other therapy if LDL-C remains above target after statin optimization.
Red flags
- Very high LDL-C with tendon xanthomas or strong family history.
- Severe hypertriglyceridemia with abdominal pain or pancreatitis risk.
Referral triggers
- Suspected familial hypercholesterolemia or genetic lipid disorders.
- Statin intolerance with persistent high risk or severe hypertriglyceridemia.