Update on Investigation and Management of Dyslipidaemias and Cardiovascular Disease Risk

Despite accounting for a quarter of all UK deaths, atherosclerotic cardiovascular disease (ASCVD) is frequently undertreated in non-specialist hospital care due to the perceived complexity of modern lipid management. This review aims to bridge the gap between evolving guidelines and routine clinical practice. We examine the advances in lipid testing, including lipoprotein (a), apolipoproteins and genetic testing, which have allowed improved and personalised risk assessment. While statins remain the foundation of lipid-lowering therapy, the treatment options have expanded and we discuss the role of ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies, inclisiran, and bempedoic acid. We also look ahead to gene-editing strategies and lipoprotein (a) lowering therapies currently in clinical trials. By simplifying these recent advances, this review aims to provide hospital clinicians with a practical approach to identify high-risk patients, optimise their therapy and reduce cardiovascular disease burden.