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Obesity and Dyslipidemia
Medication Management of Dyslipidemia:
➤ The 2026 ACC/AHA guideline strongly recommends the following
lifestyle approaches to treat or prevent hypertension in adults:
• maintaining or achieving a healthy weight
• following a heart-healthy eating pattern (such as DASH [Dietary
Approaches to Stop Hypertension])
• reducing sodium intake
• increasing dietary potassium intake
• adopting a moderate physical activity program
• managing stress
• and reducing or eliminating alcohol intake
➤ Initiate appropriate statin medication for the primary or
secondary prevention of cardiovascular disease if indicated:
• High intensity: Atorvastatin 40–80 mg, rosuvastatin 20–40 mg.
• Moderate intensity: Atorvastatin 10–20 mg, rosuvastatin 5–10 mg,
simvastatin 20–40 mg, pravastatin 40–80 mg, lovastatin 40–80 mg,
fluvastatin XL 80 mg or 40 mg twice daily, pitavastatin 1–4 mg.
• Low intensity: Simvastatin 10 mg, pravastatin 10–20 mg, lovastatin
20 mg, fluvastatin 20–40 mg.
➤ In adults aged 40 to 75 years with severe hypertriglyceridemia
(fasting triglycerides >500 mg/dL) and an ASCVD risk of >7.5%,
consider initiating statin therapy.
➤ For adults aged 40 to 75 years with fasting triglycerides of
500 mg/dL or higher, consider treatment with a very low-fat diet,
avoidance of alcohol and refined carbohydrates, increased intake
of omega-3 fatty acids (icosapent ethyl), and fibrate therapy to
prevent pancreatitis.
➤ Consider referral to adult cardiology if dyslipidemia is not well
controlled despite titration of medications or concerns for genetic
causes of hyperlipidemia.
➤ Consider referral to pediatric cardiology for treatment of
dyslipidemia in children.
