Clinical practice guideline for screening, risk assessment, and management of dyslipidemia in patients without prior cardiovascular disease

Introduction. This article summarizes the clinical practice guideline (CPG) for screening, risk assessment and management of dyslipidemia in patients without cardiovascular disease (CVD) established at the first level of care. Objective. To provide healthcare professionals with evidence-informed recommendations for screening, risk assessment, and management of dyslipidemia. Methods. A guideline development group (GDG) was formed, including specialist physicians and methodologists, who developed clinical questions using the PICO format. Systematic searches for systematic reviews were conducted in PubMed, Embase and Cochrane Library. Evidence was selected to address each clinical question formulated. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The GDG applied the GRADE methodology to review the evidence and develop recommendations, good clinical practice (GCP) points, and flowcharts. Finally, the CPG was approved with Directorial Resolution N° 003-2025-CETS/INS and subsequently rectified due to a material error with Directorial Resolution No. 005- 2025-CETS/INS. Results. The CPG addressed 4 clinical questions. Based on these questions, recommendations were formulated (1 conditional in favor and 1 conditional against), 15 BPCs, and 5 flowcharts. Among the recommendations formulated, in adults with dyslipidemia without established CVD, it is suggested to administer high-intensity statins if there is a cardiovascular risk (CVR) ≥ 10% according to HEARTS. Likewise, in adults without established CVD and mild hypertriglyceridemia (≤ 500 mg/dL), it is suggested not to administer fibrates as monotherapy for CVD. Conclusion. Evidence-based recommendations for Screening, risk assessment, and management of dyslipidemia in patients without prior cardiovascular disease at the primary care level were developed and issued.