Putting the Guidelines into Practice: Building a State-of-the-Art Lipid and Cardiometabolic Clinic-Key Implementation Highlights from the 2026 Guideline on the Management of Dyslipidemia

Video Transcription

Video Summary

The speaker highlights lipid guideline updates most relevant to CKM (cardiovascular-kidney-metabolic) clinics. Key measurement changes include using non-fasting lipid panels for screening, but fasting panels when triglycerides are >400 mg/dL. The guidelines recommend replacing the Friedewald equation with more accurate LDL-C estimators (e.g., Martin-Hopkins, NIH) and routinely reporting non–HDL-C; advanced particle testing is discouraged. ApoB measurement is newly recommended for patients with ASCVD, CKM/type 2 diabetes, or elevated triglycerides to detect residual risk after LDL-C/non–HDL-C goals are met. Absolute lipid targets return, with stricter goals for higher-risk and “very high risk” patients (LDL-C and ApoB <55 mg/dL). Lipoprotein(a) should be measured at least once, especially in CKD. Lifestyle therapy (Mediterranean/DASH diet, activity, weight management) remains foundational, with more intensive dietary restrictions as triglycerides rise and dietitian referral for TG 150–999 and >1000. Risk assessment uses PREVENT-ASCVD, risk enhancers, reproductive markers, and coronary calcium scoring. New therapy pathways add ezetimibe, PCSK9 inhibitors, bempedoic acid, inclisiran, and icosapent ethyl when indicated, with CKD stage ≥3 treated as high risk.

Meta Tag

Concept Dyslipidemia

Concept Lipoprotein Cholesterol

Concept Cardiovascular-Kidney-Metabolic Syndrome

Concept Triglyceride Level

Concept Lifestyle Intervention

Keywords

CKM lipid guideline updates

non-fasting lipid panel and triglycerides >400 mg/dL fasting

LDL-C estimation Martin-Hopkins NIH and non–HDL-C reporting

ApoB and lipoprotein(a) measurement for residual risk

ASCVD risk assessment PREVENT-ASCVD and therapies PCSK9 inclisiran bempedoic acid icosapent ethyl

Dyslipidemia

Lipoprotein Cholesterol

Cardiovascular-Kidney-Metabolic Syndrome

Triglyceride Level

Lifestyle Intervention