Risk assessment and strategies to achieve lipid goals: lessons from real-world clinical practice

Coronary heart disease (CHD) risk assessment to establish risk category and appropriate plasma lipid goals as well as achievement of those lipid goals, are important elements of treatment for dyslipidemia in clinical practice. Cases from clinical practice are presented to illustrate risk assessment and treatment in the settings of peripheral arterial disease (PAD) and heterozygous familial hypercholesterolemia (hFH). Patients with PAD are at high risk of CHD and cardiovascular mortality and may require aggressive lipid-lowering therapy irrespective of the degree of hypercholesterolemia at presentation. Risk in patients with hFH is not adequately reflected in population-based risk algorithms. Patients who have hFH should be considered at high risk for developing CHD and given aggressive lipid-modifying therapy, and family screening should be undertaken for additional case finding.