U.S. Department of Veterans Affairs and Department of Defense has released new guidelines on management of dyslipidemia.The guideline is intended to improve patient outcomes and local management of patients with dyslipidemia.

The guidelines summary has been published in the Annals of Internal Medicine.

In the guidelines the approach to managing lipid levels to reduce CVD risk, applying evidence for treatment that is concordant with the risk in the populations studied. Although the guideline is similar to that of the American College of Cardiology and American Heart Association (7), there are several important differences. First, there is less confidence in the trial data supporting lower LDL-C target levels and higher dosing of statins, especially in primary prevention. Second, the literature review was extended through May 2019. Third, the guidelines developers do not believe that the evidence supports the routine use of additional tests for risk prediction, even in intermediate-risk populations. Fourth, safety concerns (particularly with higher statin doses and combination therapy) influenced the pharmacologic treatment recommendations, which start with more conservative and safer moderate-dose statin therapy for both primary and secondary prevention, reserving upward titration for secondary prevention in higher-risk patients on the basis of shared decision making and recurrent events. Fifth, guidelines developers believe that the evidence supports a more assertive stance on aerobic activity, cardiac rehabilitation, nutrition, and supplements. Sixth, guidelines developers take a stronger position on limiting the use of laboratory testing to a more judicious, decision-oriented approach. Specifically, the guidelines developers recommend nonfasting lipid profiles, which should be repeated only every 10 years (given limited variability over time), and not at all once a goal statin dose is achieved

Key recommendations are:

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Full guideline