Modern Approaches to Dyslipidemia: Integrating Advanced Risk Markers and Imaging in Primary Care

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of preventable illness and death in the United States, underscoring the importance of effective dyslipidemia management in primary care. While lowering LDL cholesterol continues to be the cornerstone of prevention, modern practice increasingly integrates advanced lipid markers and coronary imaging to refine risk assessment and personalize treatment. This review highlights practical strategies for family physicians, including evaluation of statin intolerance, use of non-statin therapies such as ezetimibe, PCSK9 inhibitors, bempedoic acid, and icosapent ethyl, and the role of lipoprotein(a) [Lp(a)] and apolipoprotein B (ApoB) in risk stratification. Coronary artery calcium (CAC) scoring and coronary CT angiography (CTA) are discussed as complementary tools that guide preventive and diagnostic decision-making. By combining lifestyle modification, pharmacologic therapy, and advanced screening approaches, clinicians can deliver individualized cardiovascular prevention and improve long-term outcomes.