Lipid-modifying therapy according to ASCVD risk estimate

For patients at high ASCVD risk, or with established ASCVD, start lipid-modifying drug therapy in addition to lifestyle modification unless contraindicated or clinically inappropriate. Explain to the patient that to reduce overall ASCVD risk, lipid-modifying therapy is recommended even if they do not have significant dyslipidaemia.

For patients at intermediate ASCVD risk, consider starting lipid-modifying drug therapy in addition to lifestyle modification, unless contraindicated or clinically inappropriate, and in discussion with the patient about their preferences.

For patients at low ASCVD risk, the absolute benefit of lipid-modifying drug therapy is not as great as for other patients. If dyslipidaemia is present, advice and support to address lifestyle risk factors and diet to lower cholesterol is recommended initially. Lipid-modifying drug therapy can be considered in those who do not reach the LDL-C target with lifestyle support; see Target lipid concentrations according to ASCVD risk estimate for patients taking lipid-modifying therapy for target lipid concentrations.