Hyperlipidemia Management in Primary Care: A Practical Review of Risk Stratification, Guideline Directed Therapy and Emerging Lipid Lowering Treatment

Hyperlipidemia is a leading modifiable contributor to atherosclerotic cardiovascular disease (ASCVD) and the leading cause of mortality worldwide. Early identification and evidence-based management of dyslipidemia are essential components of cardiovascular risk reduction in primary care. Recent updates in lipid management guidelines including the 2026 American College of Cardiology and American Heart Association have expanded risk assessment tools, emphasized earlier measurement of lipoprotein (a), apolipoprotein B (apo-B) and coronary artery calcium (CAC), and incorporated novel lipid lowering therapy (LLT). This review provides a practical framework for primary care physicians to evaluate and manage dyslipidemia through a stepwise approach that integrates lifestyle interventions, statins, non-statin therapies and emerging agents. We summarize current evidence regarding lipid physiology, risk stratification, diagnostic strategies and guideline directed pharmacologic therapy.