Mount Carmel Health Partners Clinical Guidelines Hyperlipidemia | Page 2

Hyperlipidemia is the condition of abnormally elevated levels of any or all lipids and/or lipoproteins in the blood. Lipids are
transported in a protein capsule, a lipoprotein, the size of which determines its density (high or low).
Treatment should begin by making therapeutic lifestyle changes including weight reduction, diet modification (reduce animal
products and increase plant products), reduction in alcohol consumption, cessation of tobacco use, and increase in physical
activity levels.

Diagnosis

Treatment

Cholesterol Screening: Perform fasting (9- to 12-hour)
lipoprotein profile for adults age 20 and older once every
five years, or more frequently if clinical determines the
patient to be at increased risk for atherosclerotic disease.

For patients without atherosclerotic cardiovascular disease,
assess additional risk factors, i.e., lipids, blood pressure,
diabetes, smoking ,and family history of premature coronary
heart disease (CHD) every 4 to 6 years in patients 20 to 79
years of age.
• first degree male relatives with CHD before age 55;
• first-degree female relative with CHD before age 65.

These guidelines introduced the American College of
Cardiology (ACC)/American Heart Association (AHA)
Pooled Cohort Risk Equation (available at
http://my.americanheart.org/cvriskcalculator or as a
smartphone app) for an estimation of ten-year
cardiovascular disease risk. The calculator can be used to
determine if a high, moderate, or low dose statin is
appropriate for primary prevention. This calculator
tends to overestimate patients’ risk, particularly in
contemporary “real-world” populations of diverse sociodemographic backgrounds. We advise incorporating
discussion of the potential for overestimation into
clinician-patient decision-making.
The 2013 guidelines do not recommend titrating the
statin dose to achieve a specific LDL target as it is thought
that treating to a given target may result in undertreatment or overtreatment if an evidence-based statin
dose is not used. The addition of a non-statin
therapy has not been proven to further reduce
cardiovascular risk and, therefore, non-statins are no
longer routinely recommended.
Dyslipidemia is typically asymptomatic, but is common
and an important predictor of coronary heart disease
which is the leading cause of mortality in industrialized
countries. Cor