Module A
Module B
Module C
Obtain history and physical examination, lab tests Assess for secondary causes, familial disorder and comorbidity [L1] Obtain baseline liver function test [L2]
Obtain History, Physical Examination, and Laboratory Tests. Assess for Secondary Causes, Familial Disorders, and Comorbidity
Patient already on lipid lowering therapy?
History of ACS in past six months? [ M1 ] Ensure patient is on statin therapy and TLC (see VA/DoD IHD guideline) Sidebar 5: Lipid Lowering Therapy in patients with CVD orCVD- Equivalent (Secondary Prevention)
History of CVD or DM and LDL-C above goal? See sidebar 5 [ M2 ] Initiate lipid lowering therapy: [O]
- Drug therapy [Q1]
- Therapeutic lifestyle changes [ P] Check profile lipids 6-12 weeks Assess for adverse effects
Calculate 10-year CVD risk score (or add up risk factors) [ M3 ] Determine goal of therapy based on CVD risk See sidebar 6 [ N ] Sidebar 6: Lipid Lowering Therapy in patients based on 10-year CV risk (Primary Prevention)
Is LDL above goal based on CV risk? See sidebar 6 Initiate therapeutic lifestyle change (TLC) - diet and exercise for 3-6 months [ P ]
Reinforce lifestyle education Smoking, MNT, & Exercise [ I ] Address CV risk or comorbidities Patient responds to therapy or LDL-C at goal?
Repeat dyslipidemia evaluation in one to two years [ R ] initiate drug therapy [Q1]; Check lipid profile 6-12 weeks; Assess for adverse effects
Follow-up Treatment Continue on Algorithm C
Annotation L1 Annotation L2 Calculate 10-year CVD risk score [M3] Determine goal of therapy based on CVD risk [N]