Clinical Decision Support Tool

Dyslipidemia Management Tool Tool sa Pamamahala ng Dyslipidemia Himan sa Pagdumala sa Dyslipidemia Kasangkapan para sa Dyslipidemia

Name: Dyslipidemia Management Tool – 2026 ACC/AHA Guideline
Creator: W Rivero, MD, FPCP, DPSN

PREVENT Equations · 2026 ACC/AHA/Multisociety Guideline · Philippine Brand Names Mga Equation ng PREVENT · Alituntunin 2026 ACC/AHA · Mga Brand sa Pilipinas PREVENT Equations · 2026 ACC/AHA Guideline · Mga Brand sa Pilipinas PREVENT Equations · 2026 ACC/AHA Guideline · Mga Brand sa Pilipinas

⚠️ For clinical reference only — not endorsed by ACC/AHA. Always apply clinical judgement. Not a substitute for direct patient care.

PREVENT Equations (2023/2026) — Replace the Pooled Cohort Equations. Include kidney function (eGFR), urine protein (UACR), and Social Deprivation Index (SDI) for more accurate cardiovascular risk prediction in diverse populations.

Demographics

Age (years)

Biological Sex

Race/Ethnicity

Lipid Panel (mg/dL)

Total Cholesterol

HDL-C

LDL-C

Blood Pressure

Systolic BP (mmHg)

On BP medication

Risk Factors

Diabetes mellitus (Type 1 or 2) Current smoker (cigarettes within past 30 days) Currently on statin therapy

Kidney Function

eGFR (mL/min/1.73m²) Leave blank if unknown

UACR Optional Urine albumin-to-creatinine ratio

Optional Inputs Enhances accuracy

HbA1c Optional

Social Deprivation Index Optional SDI ≥50 increases CV risk

2026 ACC/AHA Guideline — Hypertriglyceridemia management is tiered by severity. Lifestyle modification is first-line for all levels. Pharmacotherapy targets differ by TG range and residual ASCVD risk.

Triglyceride Level

Fasting Triglycerides (mg/dL)

ASCVD / CV Risk Status

Diabetes mellitus CKD (eGFR <60) Prior pancreatitis

Statin Intensity & Philippine Brand Names

Prices and availability vary. Generic equivalents are available for most statins. Verify current stock with your pharmacy.

Intensity	Drug & Dose	LDL↓	PH Brand Names
High	Atorvastatin 40–80 mg	≥50%	Lipitor Atostat Atorvastatin (generics)
High	Rosuvastatin 20–40 mg	≥50%	Crestor Rosuphar Rosuva (generics)
Moderate	Atorvastatin 10–20 mg	30–49%	Lipitor Atorvastatin (generics)
Moderate	Rosuvastatin 5–10 mg	30–49%	Crestor Rosuvastatin (generics)
Moderate	Simvastatin 20–40 mg	30–49%	Zocor Simtin Simvastatin (generics)
Moderate	Pravastatin 40–80 mg	30–49%	Pravachol Pravastatin (generics)
Moderate	Pitavastatin 2–4 mg	30–49%	Livalo Pitava
Low	Simvastatin 10 mg	<30%	Simvastatin (generics)
Low	Fluvastatin 20–40 mg	<30%	Lescol

Non-Statin Agents & Philippine Availability

Agent	Mechanism	LDL↓	PH Brand	Notes
Ezetimibe 10 mg	NPC1L1 inhibitor (intestinal cholesterol absorption)	15–25%	EzetrolZetia	Add-on to statin; also available as Vytorin (ezetimibe + simvastatin 10/20 or 10/40)
Evolocumab	PCSK9 inhibitor (monoclonal antibody)	50–60%	Repatha	140 mg SC q2w or 420 mg SC monthly; expensive — specialist referral
Alirocumab	PCSK9 inhibitor (monoclonal antibody)	45–60%	Praluent	75–150 mg SC q2w; limited local availability
Inclisiran	PCSK9 siRNA (gene silencing)	~50%	Leqvio	284 mg SC at 0, 3 mo, then q6 months; not yet widely available PH
Bempedoic acid	ATP-citrate lyase inhibitor	15–25%	Limited PH availability	For statin-intolerant patients; avoid if eGFR <30

LDL-C Treatment Goals — 2026 ACC/AHA

Risk Category	LDL-C Goal	Non-HDL Goal	ApoB Goal
Secondary — Very High Risk (VHR) ≥2 events OR 1 event + high-risk features	<55 mg/dL	<85 mg/dL	<55 mg/dL
Secondary — Not VHR 1 major ASCVD event, no high-risk features	≤70 mg/dL	<100 mg/dL	<70 mg/dL
Primary — High Risk (≥10%) Including DM or FH	<70 mg/dL	<100 mg/dL	<70 mg/dL
Primary — Intermediate (5–<10%)	<100 mg/dL	<130 mg/dL	<90 mg/dL
Primary — Borderline (3–<5%) Consider if risk enhancers present	<100 mg/dL	<130 mg/dL	<90 mg/dL
Primary — Low Risk (<3%)	Lifestyle first; statin if LDL ≥190	—	—
FH / LDL-C ≥190 mg/dL	<70 mg/dL or ≥50% ↓	<100 mg/dL	<70 mg/dL

CAC Score Thresholds & LDL Goals

CAC Score	Implication	LDL Target
0 (no detectable CAC)	Low risk — can defer statin in borderline/intermediate	Lifestyle modification; reassess in 5 yr
1–99 Agatston Units	Mild coronary atherosclerosis	<100 mg/dL
100–299 AU	Moderate atherosclerosis — treat as high-risk primary	<70 mg/dL
≥300 AU (or ≥75th percentile for age/sex)	Extensive atherosclerosis	<70 mg/dL
≥1000 AU	Very high coronary atherosclerosis burden	<55 mg/dL

Lipoprotein(a) & Risk-Enhancing Factors

Factor	Threshold	Clinical Impact
Lp(a)	≥125 nmol/L (≥50 mg/dL)	Risk-enhancing — may upscale therapy in borderline/intermediate
Lp(a) (very high)	≥250 nmol/L	Independent ≥2× CV risk increase; consider PCSK9i
hs-CRP	≥2.0 mg/L	Inflammatory risk enhancer
ABI	<0.9	Peripheral artery disease indicator — risk enhancer
Premature ASCVD	Men <55, women <65	Strong family history — risk enhancer
Chronic inflammation	Autoimmune / HIV / psoriasis	Raises residual risk
Preeclampsia history	—	Women's risk enhancer
Metabolic syndrome	3 of 5 criteria	Risk enhancer

Source: Grundy SM, et al. 2026 ACC/AHA/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. J Am Coll Cardiol. 2026. This tool implements the clinical algorithms in original code. Not an official ACC/AHA product. Dr. Rivero bears sole responsibility for this implementation.

Written by

W Rivero, MD, FPCP, DPSN

Nephrology · Internal Medicine · Philippines

Last reviewed: June 2026