The slide is a title page titled "Dyslipidaemia Management 2025." Its subtitle highlights key updates for primary care based on the 2025 ESC/EAS Guidelines for the Management of Dyslipidaemias.

Dyslipidaemia Management 2025

Key Updates for Primary Care — Based on the 2025 ESC/EAS Guidelines for the Management of Dyslipidaemias

Source: ESC/EAS

Dyslipidaemia drives cardiovascular disease (CVD) risk, and targeted LDL-C lowering reduces CVD events. 2025 updates refine primary care risk assessment, with ESC data highlighting substantial clinical impact.

Why This Matters

• Dyslipidaemia drives cardiovascular disease (CVD) risk
• 2025 updates refine primary care risk assessment
• Targeted LDL-C lowering reduces CVD events
• ESC data highlights substantial clinical impact

Source: 2025 ESC/EAS Guidelines for Dyslipidaemias

The slide displays a risk stratification table for SCORE2 (under 70 years) and SCORE2-OP (70 years and older). It categorizes CVD risk as Low (<5%), Moderate (5-10%), High (10-20%), and Very High (≥20%), with identical thresholds for both models.

Risk Stratification: SCORE2 / SCORE2-OP

{ "headers": [ "Risk Category", "SCORE2 (<70y)", "SCORE2-OP (≥70y)" ], "rows": [ [ "Low", "<5%", "<5%" ], [ "Moderate", "5-10%", "5-10%" ], [ "High", "10-20%", "10-20%" ], [ "Very High", "≥20%", "≥20%" ] ] }

Source: 2025 ESC/EAS Guidelines

The slide specifies LDL-C targets by cardiovascular risk level. Very high risk (ASCVD, FH, SCORE2 ≥10%) aims for <1.4 mmol/L (55 mg/dL); high risk (SCORE2 5-10%, diabetes) <1.8 mmol/L (70 mg/dL); moderate risk (SCORE2 3-5%, CKD stage 3) <2.6 mmol/L (100 mg/dL).

LDL-C Targets by Risk

• <1.4 mmol/L (55 mg/dL): Very High Risk

ASCVD, FH, or SCORE2 ≥10%

• <1.8 mmol/L (70 mg/dL): High Risk

SCORE2 5-10% or diabetes

• <2.6 mmol/L (100 mg/dL): Moderate Risk

SCORE2 3-5% or CKD stage 3 Source: 2025 ESC/EAS Guidelines

The slide specifies lipid-lowering therapy initiation thresholds: LDL-C >1.8 mmol/L for very high risk and >2.6 mmol/L for high risk patients. Intensity is selected based on baseline LDL-C and risk category, following ESC guidelines for primary care.

Treatment Initiation Thresholds

• Start lipid-lowering therapy if LDL-C >1.8 mmol/L (very high risk)
• Initiate if LDL-C >2.6 mmol/L (high risk)
• Select intensity based on baseline LDL-C and risk category
• Follow ESC thresholds for primary care decisions

Source: 2025 ESC/EAS Guidelines

The slide outlines a stepwise pharmacological therapy for LDL-C reduction, starting with high-intensity statins, adding ezetimibe if goals aren't met, and using PCSK9 inhibitors for high-risk non-responders. It also highlights bempedoic acid as an oral alternative for statin-intolerant patients, with tailoring to ESC doses and indications.

Pharmacological Therapy

{ "features": [ { "icon": "🎯", "heading": "High-Intensity Statins First", "description": "Initiate potent statins to aggressively lower LDL-C per ESC targets." }, { "icon": "➕", "heading": "Ezetimibe Add-On", "description": "Combine with statins if LDL-C goals not achieved." }, { "icon": "💉", "heading": "PCSK9-i Non-Responders", "description": "For high-risk patients failing statin + ezetimibe therapy." }, { "icon": "🔄", "heading": "Bempedoic Acid Alternative", "description": "Oral option for statin-intolerant patients reducing LDL-C." }, { "icon": "📋", "heading": "ESC Doses & Indications", "description": "Tailor therapy to specific doses and patient profiles." } ] }

Source: 2025 ESC/EAS Guidelines

The "Special Cases" slide addresses managing elevated Lp(a) >50 mg/dL with screening and targeted therapies, alongside hypertriglyceridemia (TG >150 mg/dL) using lifestyle changes, statins, fibrates, or omega-3s to lower ASCVD risk. It also covers adapting lipid-lowering strategies for HIV and cancer therapies due to drug interactions, prioritizing statins less affected by CYP3A4 and closely monitoring LDL-C.

Special Cases

Source: 2025 ESC/EAS Guidelines for the Management of Dyslipidaemias

The Primary Care Workflow outlines a five-step process for managing cardiovascular risk: assessing 10-year SCORE2 risk (categorizing as low to very high), measuring baseline LDL-C against risk-based targets, and initiating high-intensity statin ± ezetimibe. It continues with titration and monitoring (rechecking LDL-C in 4-12 weeks, ensuring ≥50% reduction, and checking LFTs/CK), followed by referral to a lipid specialist for persistent high LDL-C, intolerance, or complex cases like FH.

Primary Care Workflow

{ "headers": [ "Step", "Actions", "Notes / Criteria" ], "rows": [ [ "Assess risk (SCORE2)", "Calculate SCORE2 (or SCORE2-OP) 10-year CV risk", "Categorize: low (<5%), mod (5-10%), high (10-20%), very high (>20%)" ], [ "LDL-C test", "Measure baseline LDL-C", "Fasting/non-fasting; establish against risk-based targets (e.g., <1.8 mmol/L very high risk)" ], [ "Initiate statin ± ezetimibe", "Start high-intensity statin; add ezetimibe if LDL-C > threshold", "Very high risk: statin + ezetimibe if >1.8 mmol/L at outset" ], [ "Titrate / monitor", "Titrate to LDL-C target; recheck LDL-C 4-12 weeks; assess adherence / side effects", "Intensify if not at goal (≥50% reduction); monitor LFTs, CK if symptoms" ], [ "Refer if needed", "Refer to lipid specialist", "Persistent >target LDL-C, statin intolerance, or complex cases (e.g., FH)" ] ] }

Source: 2025 ESC/EAS Guidelines for Dyslipidaemias

The timeline for monitoring lipids and LFTs begins with a baseline assessment before therapy and an early safety check at 4-12 weeks post-start. It continues with checks every 3-12 months until LDL-C target achievement, annual follow-up thereafter, and therapy adjustments as needed for efficacy and tolerability.

Monitoring & Follow-Up

Baseline: Initial Assessment Measure lipids and LFTs before therapy initiation. 4-12 Weeks: Early Safety Check Reassess lipids and LFTs 4-12 weeks post-start. 3-12 Months: Titration Monitoring Check lipids every 3-12 months until LDL-C target. Annually: Maintenance Follow-Up Annual lipids and LFTs once target achieved. As Needed: Response Adjustment Modify therapy based on efficacy and tolerability.

Source: 2025 ESC/EAS Guidelines for the Management of Dyslipidaemias

The slide's key takeaways urge adopting SCORE2 for risk stratification, aggressively targeting LDL-C goals with combination therapy, and empowering primary care to reduce CVD events. It closes with a call to transform care today, explore ESC resources and guidelines, and visit ESC for questions.

Key Takeaways

**Key Takeaways:

• Adopt SCORE2 for accurate risk stratification
• Aggressively target LDL-C goals with combo Rx
• Empower primary care to reduce CVD events

Closing: Transform care today!

Call-to-Action: Explore ESC resources and guidelines now.**

Questions? Visit ESC for more.

Source: Dyslipidaemia Management 2025: Key Updates for Primary Care — Based on the 2025 ESC/EAS Guidelines