{
  "schemaVersion": 2,
  "eyebrow": "Preventive Cardiology",
  "title": "Hyperlipidemia",
  "summary": "Manage hyperlipidemia by separating established ASCVD, severe LDL-C elevation, and risk-based primary prevention; use statins as the foundation, refine borderline decisions with coronary artery calcium, and add nonstatins when LDL-C reduction is inadequate or statins are not tolerated.",
  "seoDescription": "Physician guide to hyperlipidemia management: ASCVD prevention, statin selection, coronary calcium use, familial hypercholesterolemia, and nonstatins.",
  "clinicalQuestion": "How should physicians stratify hyperlipidemia and select lipid-lowering therapy for ASCVD prevention?",
  "specialty": "Cardiology and Internal Medicine",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "hyperlipidemia",
    "dyslipidemia",
    "statins",
    "primary prevention",
    "secondary prevention",
    "coronary artery calcium",
    "familial hypercholesterolemia",
    "PCSK9 inhibitors",
    "bempedoic acid"
  ],
  "keyTakeaways": [
    "Use high-intensity statin therapy for secondary prevention in patients with established ASCVD. [2]",
    "For primary prevention in adults aged 40 to 75 years with at least one cardiovascular risk factor, prescribe a statin at estimated 10-year CVD risk of 10% or greater; selectively offer one at risk of 7.5% to less than 10%. [8]",
    "A coronary artery calcium score of 0 can support deferring statin therapy in selected primary-prevention patients, but not when diabetes, smoking, poorly controlled hypertension, genetic dyslipidemia, elevated lipoprotein(a), or a strong family history of premature ASCVD is present. [4]",
    "LDL-C of at least 190 mg/dL should prompt treatment as severe hypercholesterolemia and evaluation for familial hypercholesterolemia, including family assessment and cascade screening. [13][15]",
    "For patients unable to take an adequate statin regimen or needing further LDL-C reduction, ezetimibe, PCSK9 inhibitors, and bempedoic acid are evidence-based nonstatin options. [6][14]"
  ],
  "sections": [
    {
      "id": "triage-by-prevention-group",
      "eyebrow": "Initial decision",
      "heading": "Assign the prevention group before choosing therapy",
      "intro": "The indication for lipid-lowering therapy is driven by ASCVD status, LDL-C severity, and estimated primary-prevention risk.",
      "paragraphs": [
        "First determine whether the patient has established ASCVD. In secondary prevention, high-intensity statin therapy is recommended; this group should not be managed as risk-calculator primary prevention. [2]",
        "For adults without known ASCVD, separate severe hypercholesterolemia (LDL-C at least 190 mg/dL) from risk-based primary prevention. The ACC/AHA framework cited in HIV guidance identifies LDL-C at least 190 mg/dL in adults aged 20 to 75 years as an indication for statin-based primary prevention, independent of calculated 10-year risk. [13]",
        "For adults aged 40 to 75 years without ASCVD and without severe LDL-C elevation, estimate 10-year cardiovascular risk and identify dyslipidemia, diabetes, hypertension, or smoking. USPSTF recommends prescribing a statin when at least one such risk factor is present and estimated 10-year CVD risk is at least 10%; at 7.5% to less than 10%, offer a statin selectively because expected benefit is smaller. [8]",
        "Evidence is insufficient to determine the overall balance of benefits and harms for initiating statins for primary prevention after age 75 years; make this a patient-specific decision rather than automatically extending the 40-to-75-year threshold. [8]"
      ],
      "bullets": [
        "Established ASCVD: initiate or maintain high-intensity statin therapy. [2]",
        "LDL-C at least 190 mg/dL, age 20 to 75 years: treat as severe hypercholesterolemia and assess for familial hypercholesterolemia. [13][15]",
        "Age 40 to 75 years with at least one risk factor and 10-year CVD risk at least 10%: prescribe statin therapy. [8]",
        "Age 40 to 75 years with at least one risk factor and 10-year CVD risk 7.5% to less than 10%: selectively offer statin therapy after discussing smaller expected benefit. [8]"
      ],
      "subsections": [],
      "table": {
        "caption": "Treatment-entry decisions for common hyperlipidemia presentations. [2][8][13]",
        "columns": [
          "Clinical branch",
          "Action that follows"
        ],
        "rows": [
          [
            "Established ASCVD",
            "Use high-intensity statin therapy for secondary prevention. [2]"
          ],
          [
            "LDL-C at least 190 mg/dL, age 20 to 75 years",
            "Use statin-based prevention without relying on a 10-year risk estimate; evaluate for familial hypercholesterolemia. [13][15]"
          ],
          [
            "No ASCVD, age 40 to 75 years, at least one risk factor, 10-year CVD risk at least 10%",
            "Prescribe a statin. [8]"
          ],
          [
            "No ASCVD, age 40 to 75 years, at least one risk factor, 10-year CVD risk 7.5% to less than 10%",
            "Selectively offer a statin; expected benefit is smaller. [8]"
          ],
          [
            "No ASCVD, age older than 75 years",
            "Individualize initiation because evidence is insufficient to define net primary-prevention benefit. [8]"
          ]
        ]
      }
    },
    {
      "id": "resolve-primary-prevention-uncertainty",
      "eyebrow": "Risk refinement",
      "heading": "Use coronary artery calcium when the statin decision remains uncertain",
      "intro": "CAC is most useful when risk estimation and patient preference do not yield a clear primary-prevention decision.",
      "paragraphs": [
        "When a primary-prevention statin decision remains uncertain, coronary artery calcium can reclassify risk. A CAC score of 0 may support downgrading risk and deferring statin therapy, but do not use zero CAC as a reason to defer therapy in patients who smoke, have diabetes, poorly controlled hypertension, genetic dyslipidemia such as familial hypercholesterolemia or elevated lipoprotein(a), or a strong family history of premature ASCVD. [4]",
        "For CAC 1 to 99, ACC/AHA guidance supports statin initiation in patients aged 55 years or older. A nonzero CAC result therefore shifts a previously equivocal conversation toward pharmacotherapy, particularly in this age group. [4]"
      ],
      "bullets": [
        "CAC = 0: consider deferral only after excluding diabetes, active smoking, poorly controlled hypertension, genetic dyslipidemia/elevated lipoprotein(a), and strong premature-ASCVD family history. [4]",
        "CAC 1-99 and age at least 55 years: favor statin initiation. [4]"
      ],
      "subsections": [],
      "table": {
        "caption": "CAC interpretation for statin decisions in primary prevention. [4]",
        "columns": [
          "CAC result",
          "Interpretation",
          "Next action"
        ],
        "rows": [
          [
            "0",
            "May identify lower near-term risk, but does not negate high-risk clinical features. [4]",
            "Consider deferring statin only if diabetes, smoking, poorly controlled hypertension, genetic dyslipidemia/elevated lipoprotein(a), and strong premature-ASCVD family history are absent. [4]"
          ],
          [
            "1-99",
            "Supports atherosclerotic plaque burden; guideline rationale favors treatment at age 55 years or older. [4]",
            "Initiate a statin in patients aged 55 years or older. [4]"
          ]
        ]
      }
    },
    {
      "id": "severe-ldl-and-familial-hypercholesterolemia",
      "eyebrow": "Genetic dyslipidemia",
      "heading": "Evaluate LDL-C at least 190 mg/dL for familial hypercholesterolemia",
      "intro": "Marked LDL-C elevation changes both treatment urgency and family-level prevention.",
      "paragraphs": [
        "Familial hypercholesterolemia is an autosomal dominant disorder of LDL metabolism affecting approximately 1 in 200 to 300 individuals. In a patient with severe LDL-C elevation, obtain family and medical history and perform physical examination as part of case identification; these elements, together with lipid measurements, are central to recognizing affected patients. [15]",
        "Once familial hypercholesterolemia is suspected or established, pursue cascade screening of relatives. This converts an individual lipid result into a preventive intervention for first-degree and extended family members at risk of the same inherited disorder. [15]",
        "Lifestyle measures remain appropriate but often do not achieve LDL reduction goals in familial hypercholesterolemia, so do not delay pharmacologic LDL lowering while relying on lifestyle change alone. [15]"
      ],
      "bullets": [
        "Ask specifically about premature ASCVD and known severe hypercholesterolemia in relatives. [15]",
        "Use lipid measurements, family history, medical history, and examination to identify familial hypercholesterolemia. [15]",
        "Offer cascade screening when familial hypercholesterolemia is identified. [15]"
      ],
      "subsections": [],
      "table": {
        "caption": "Findings that should redirect management toward familial hypercholesterolemia evaluation. [13][15]",
        "columns": [
          "Finding",
          "Clinical implication",
          "Next step"
        ],
        "rows": [
          [
            "LDL-C at least 190 mg/dL in an adult aged 20 to 75 years",
            "Meets a statin-treatment entry criterion and raises concern for severe inherited hypercholesterolemia. [13]",
            "Initiate statin-based treatment and assess for familial hypercholesterolemia. [13][15]"
          ],
          [
            "Autosomal dominant familial pattern or affected relatives",
            "Supports an inherited LDL-metabolism disorder. [15]",
            "Expand assessment beyond the index patient with cascade screening. [15]"
          ],
          [
            "Lifestyle response inadequate for LDL lowering",
            "Lifestyle alone is commonly insufficient in familial hypercholesterolemia. [15]",
            "Use lipid-lowering pharmacotherapy rather than prolonged lifestyle-only management. [15]"
          ]
        ]
      }
    },
    {
      "id": "nonstatin-escalation-and-intolerance",
      "eyebrow": "Therapy escalation",
      "heading": "Add evidence-based nonstatins when statins are inadequate or not tolerated",
      "intro": "Statins remain first-line; nonstatins are selected for residual LDL-C elevation or clinically meaningful statin intolerance.",
      "paragraphs": [
        "Statins are first-line lipid-lowering therapy because they have LDL-C-lowering efficacy, event-reduction evidence, and favorable cost-effectiveness across primary and secondary prevention. Before labeling a patient statin intolerant, determine whether any statin regimen is tolerated, because nonstatin therapy is generally used in addition to maximally tolerated statin therapy or when intolerance prevents adequate statin use. [6]",
        "Ezetimibe, PCSK9 inhibitors, and bempedoic acid each lower LDL-C and have evidence supporting reduction in major adverse cardiovascular events in high-risk or statin-intolerant populations. Their use is most clinically relevant when ASCVD risk is high and LDL-C remains inadequately controlled with a tolerated statin regimen, or when statin adverse effects preclude an adequate regimen. [6]",
        "Bempedoic acid is FDA-approved as an adjunct to maximally tolerated statin therapy for LDL-C lowering in patients with ASCVD or heterozygous familial hypercholesterolemia. The bempedoic acid-ezetimibe combination is also FDA-approved as an adjunct to diet and statin therapy for adults with ASCVD or heterozygous familial hypercholesterolemia who require additional LDL-C reduction. [14]",
        "For patients with diabetes who are statin intolerant, the cited 2024 ADA guidance recommends bempedoic acid as an alternative LDL-lowering strategy to reduce cardiovascular events. [14]"
      ],
      "bullets": [
        "Residual LDL-C elevation despite maximally tolerated statin in high-risk disease: consider ezetimibe, a PCSK9 inhibitor, or bempedoic acid based on indication and treatment burden. [6][14]",
        "Statin intolerance: use an evidence-based nonstatin rather than abandoning LDL-C lowering; bempedoic acid is an FDA-approved option in ASCVD or heterozygous familial hypercholesterolemia. [14]",
        "Diabetes with statin intolerance: bempedoic acid is recommended by the cited ADA 2024 guidance as an alternative strategy to reduce cardiovascular events. [14]"
      ],
      "subsections": [],
      "table": {
        "caption": "Nonstatin selection principles for patients needing additional LDL-C lowering. [6][14]",
        "columns": [
          "Clinical situation",
          "Therapeutic option",
          "Evidence-supported role"
        ],
        "rows": [
          [
            "High-risk patient with inadequate LDL-C reduction on tolerated statin",
            "Ezetimibe, PCSK9 inhibitor, or bempedoic acid",
            "Each is an evidence-based nonstatin option that lowers LDL-C; these therapies have MACE-reduction evidence in appropriate populations. [6]"
          ],
          [
            "ASCVD or heterozygous familial hypercholesterolemia requiring additional LDL-C reduction",
            "Bempedoic acid",
            "FDA-approved as adjunct to maximally tolerated statin therapy. [14]"
          ],
          [
            "ASCVD or heterozygous familial hypercholesterolemia requiring additional LDL-C reduction",
            "Bempedoic acid plus ezetimibe",
            "FDA-approved combination adjunct to diet and statin therapy. [14]"
          ],
          [
            "Diabetes with statin intolerance",
            "Bempedoic acid",
            "Recommended by cited ADA 2024 guidance as an alternative LDL-lowering strategy to reduce cardiovascular events. [14]"
          ]
        ]
      }
    },
    {
      "id": "hiv-specific-considerations",
      "eyebrow": "Risk-enhancing condition",
      "heading": "Individualize primary prevention in people with HIV",
      "intro": "HIV can alter the risk discussion, particularly when conventional risk estimates underrepresent clinical risk.",
      "paragraphs": [
        "For people with HIV aged 40 to 75 years, use ACC/AHA/Multisociety dyslipidemia guidance for statin-based primary prevention. For those younger than 40 years, there is no HIV-specific ACC/AHA recommendation; use shared decision-making informed by HIV-related risk factors and ACC/AHA risk enhancers. [10]",
        "For a patient with HIV whose calculated risk creates uncertainty, explicitly incorporate HIV-related factors and conventional risk enhancers into the treatment discussion rather than treating a low calculated estimate as a categorical reason against statin therapy. [10]"
      ],
      "bullets": [
        "HIV age 40-75 years: follow ACC/AHA/Multisociety statin guidance for primary prevention. [10]",
        "HIV age under 40 years: individualize the decision using HIV-related risk factors, ACC/AHA risk enhancers, and shared decision-making. [10]"
      ],
      "subsections": [],
      "table": {
        "caption": "Primary-prevention statin approach in people with HIV. [10]",
        "columns": [
          "Age group",
          "Decision approach"
        ],
        "rows": [
          [
            "40-75 years",
            "Follow ACC/AHA/Multisociety dyslipidemia guidance for statin therapy in primary prevention. [10]"
          ],
          [
            "Under 40 years",
            "No HIV-specific ACC/AHA statin recommendation; individualize with HIV-related risk factors, ACC/AHA risk enhancers, and shared decision-making. [10]"
          ]
        ]
      }
    }
  ],
  "faq": [],
  "references": [
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    {
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    {
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    {
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    },
    {
      "number": 7,
      "title": "ESC 365 - Doctor Jelena Pavlovic",
      "detail": "esc365.escardio.org",
      "url": "https://esc365.escardio.org/person/457377",
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      "host": "esc365.escardio.org"
    },
    {
      "number": 8,
      "title": "USPSTF Releases Updated Statin Guidelines For Primary Prevention of CVD - American College of Cardiology",
      "detail": "www.acc.org",
      "url": "https://www.acc.org/Latest-in-Cardiology/Articles/2022/08/23/18/48/USPSTF-Releases-Updated-Statin-Guidelines-For-Primary-Prevention-of-CVD",
      "authors": "www.acc.org",
      "host": "www.acc.org"
    },
    {
      "number": 9,
      "title": "USPSTF Releases Updated Statin Guidelines For Primary ...",
      "detail": "www.acc.org",
      "url": "https://www.acc.org/latest-in-cardiology/articles/2022/08/23/18/48/uspstf-releases-updated-statin-guidelines-for-primary-prevention-of-cvd",
      "authors": "www.acc.org",
      "host": "www.acc.org"
    },
    {
      "number": 10,
      "title": "Update on Statin Therapy as Primary Prevention of Atherosclerotic Cardiovascular Disease in People With HIV | NIH",
      "detail": "clinicalinfo.hiv.gov",
      "url": "https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/statin-therapy-people-hiv",
      "authors": "clinicalinfo.hiv.gov",
      "host": "clinicalinfo.hiv.gov"
    },
    {
      "number": 11,
      "title": "The HHS Panel on Antiretroviral Guidelines for Adults and Adolescents With HIV Announces Changes to Statin Therapy Guidance | NIH",
      "detail": "clinicalinfo.hiv.gov",
      "url": "https://clinicalinfo.hiv.gov/en/news/hhs-panel-antiretroviral-guidelines-adults-and-adolescents-hiv-announces-changes-statin",
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    },
    {
      "number": 13,
      "title": "[PDF] Statin Therapy in People with HIV",
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      "host": "clinicalinfo.hiv.gov"
    },
    {
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    },
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      "host": "www.ncbi.nlm.nih.gov"
    }
  ],
  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
  "citations": [
    {
      "number": 1,
      "title": "Rosuvastatin for Primary Prevention in Older Persons With Elevated ...",
      "detail": "annals.org",
      "url": "https://annals.org/aim/article-abstract/745730/rosuvastatin-primary-prevention-older-persons-elevated-c-reactive-protein-low",
      "authors": "annals.org",
      "host": "annals.org",
      "snippet": "ACC/AHA Cholesterol Guidelines Current Drug Treatment of Hyperlipidemia in Older Adults Statins in the Elderly: A Patient-Focused Approach What",
      "score": 0.59401023
    },
    {
      "number": 2,
      "title": "Dyslipidemia | Annals of Internal Medicine - ACP Journals",
      "detail": "annals.org",
      "url": "https://annals.org/article.aspx?doi=10.7326%2FAITC201712050",
      "authors": "annals.org",
      "host": "annals.org",
      "snippet": "For secondary prevention, high-intensity statin therapy is recommended. A primary prevention strategy is used for patients at high risk for",
      "score": 0.5849357
    },
    {
      "number": 3,
      "title": "Management of Dyslipidemia for Cardiovascular Disease Risk ...",
      "detail": "annals.org",
      "url": "https://annals.org/article.aspx?articleid=2337281",
      "authors": "annals.org",
      "host": "annals.org",
      "snippet": "In December 2014, a joint clinical practice guideline was approved for management of dyslipidemia to reduce cardiovascular risk in adults.",
      "score": 0.4928966
    },
    {
      "number": 4,
      "title": "Comparison of Transatlantic Approaches to Lipid Management: The AHA/ACC/Multisociety Guidelines vs the ESC/EAS Guidelines - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0025619620300471",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "### Major Global Coronary Artery Calcium Guidelines\n\nThe CCS makes an exception and adds that statin therapy should be considered in patients with zero CAC, if positive for the following risk factors: history of cigarette smoking, diabetes, poorly controlled hypertension, genetic dyslipidemias such ",
      "score": 0.6829338
    },
    {
      "number": 5,
      "title": "2017 Taiwan lipid guidelines for high risk patients",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0929664616304302",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid",
      "score": 0.60049355
    },
    {
      "number": 6,
      "title": "PCSK9 inhibitor, ezetimibe, and bempedoic acid: Evidence-based therapies for statin-intolerant patients - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0033062023000130",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: PCSK9 inhibitor, ezetimibe, and bempedoic acid: Evidence-based therapies for statin-intolerant patients - ScienceDirect\nStatins are first-line therapy for treating dyslipidemia because of their low-density lipoprotein cholesterol (LDL-C) lowering efficacy, superior event-reduction data and un",
      "score": 0.6216563
    },
    {
      "number": 7,
      "title": "ESC 365 - Doctor Jelena Pavlovic",
      "detail": "esc365.escardio.org",
      "url": "https://esc365.escardio.org/person/457377",
      "authors": "esc365.escardio.org",
      "host": "esc365.escardio.org",
      "snippet": "Title: ESC 365 - Doctor Jelena Pavlovic\n##### Menu. #### Doctor Jelena Pavlovic Follow. Erasmus University Medical Centre, Rotterdam (Netherlands (The)). #### Doctor Jelena Pavlovic Follow. Erasmus University Medical Centre, Rotterdam (Netherlands (The)). #### Biography. Jelena Pavlovic is an epidem",
      "score": 0.7304634
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    {
      "number": 8,
      "title": "USPSTF Releases Updated Statin Guidelines For Primary Prevention of CVD - American College of Cardiology",
      "detail": "www.acc.org",
      "url": "https://www.acc.org/Latest-in-Cardiology/Articles/2022/08/23/18/48/USPSTF-Releases-Updated-Statin-Guidelines-For-Primary-Prevention-of-CVD",
      "authors": "www.acc.org",
      "host": "www.acc.org",
      "snippet": "Highlights include a recommendation that clinicians prescribe a statin for the primary prevention of cardiovascular disease for adults ages 40 to 75 years who have one or more cardiovascular disease risk factors, such as dyslipidemia, diabetes, hypertension, or smoking, and an estimated 10-year card",
      "score": 0.7120925
    },
    {
      "number": 9,
      "title": "USPSTF Releases Updated Statin Guidelines For Primary ...",
      "detail": "www.acc.org",
      "url": "https://www.acc.org/latest-in-cardiology/articles/2022/08/23/18/48/uspstf-releases-updated-statin-guidelines-for-primary-prevention-of-cvd",
      "authors": "www.acc.org",
      "host": "www.acc.org",
      "snippet": "Meanwhile, a third editorial published in JAMA Cardiology from Neil J. Stone, MD, FACC; Philip Greenland, MD, FACC; and Scott M. Grundy, MD, PhD, compares the differences between the USPSTF statin recommendations with the treatment algorithm for primary prevention included as part of the current 201",
      "score": 0.69672287
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    {
      "number": 10,
      "title": "Update on Statin Therapy as Primary Prevention of Atherosclerotic Cardiovascular Disease in People With HIV | NIH",
      "detail": "clinicalinfo.hiv.gov",
      "url": "https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/statin-therapy-people-hiv",
      "authors": "clinicalinfo.hiv.gov",
      "host": "clinicalinfo.hiv.gov",
      "snippet": "|  For people with HIV aged 40–75 years, the ACC/AHA/Multisociety Dyslipidemia Management Guideline recommends statin therapy for primary prevention of ASCVD.  For people with HIV aged <40 years, the ACC/AHA/Multisociety Dyslipidemia Management Guideline does not issue a recommendation specific to p",
      "score": 0.6041426
    },
    {
      "number": 11,
      "title": "The HHS Panel on Antiretroviral Guidelines for Adults and Adolescents With HIV Announces Changes to Statin Therapy Guidance | NIH",
      "detail": "clinicalinfo.hiv.gov",
      "url": "https://clinicalinfo.hiv.gov/en/news/hhs-panel-antiretroviral-guidelines-adults-and-adolescents-hiv-announces-changes-statin",
      "authors": "clinicalinfo.hiv.gov",
      "host": "clinicalinfo.hiv.gov",
      "snippet": "In March 2026, an updated American College of Cardiology (ACC)/American Heart Association (AHA)/Multisociety Dyslipidemia Management Guideline included new recommendations for statin therapy specifically for people with HIV. Because these recommendations were developed by experts in dyslipidemia man",
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      "title": "Statins for Prevention of Cardiovascular Disease in Adults",
      "detail": "uat.ajnr.org",
      "url": "https://uat.ajnr.org/lookup/external-ref?access_num=10.1001%2Fjama.2015.15629&link_type=DOI",
      "authors": "uat.ajnr.org",
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      "snippet": "New Dyslipidemia Guidelines Lower the Lipid Treatment Goals and Raise the Bar for Clinical Practice ... 2013 ACC/AHA guideline on the treatment",
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      "snippet": "control, and lipid lowering for those with hyperlipidemia. Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (i.e., statins) may offer advantages for people with HIV over other prevention strategies, given that statin therapy is associated with a well-described reduction in ASCVD event",
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      "title": "Bempedoic Acid - StatPearls - NCBI Bookshelf",
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      "snippet": "Title: Bempedoic Acid - StatPearls - NCBI Bookshelf\nBempedoic acid is a lipid-lowering agent pivotal in managing patients with elevated low-density lipoprotein cholesterol (LDL-C) levels. * Screen patients for potential contraindications, drug interactions, and adverse effects of bempedoic acid befo",
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      "title": "Familial Hypercholesterolemia - Endotext - NCBI Bookshelf",
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      "url": "https://www.ncbi.nlm.nih.gov/books/NBK395572",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "35.\n:   McCrindle BW, Ose L, Marais AD. Efficacy and safety of atorvastatin in children and adolescents with familial hypercholesterolemia or severe hyperlipidemia: a multicenter, randomized, placebo-controlled trial. J Pediatr. 2003;143(1):74-80. doi:10.1016/S0022-3476(03)00186-0 [PubMed: 12915827]",
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