High blood cholesterol is a major risk factor for heart disease, and heart disease is the leading cause of death in the United States. Population health approaches have attempted to reduce the prevalence of hyperlipidemia through screening and by increasing public awareness of high cholesterol and strategies for reducing it. Physicians are in a unique position to counsel, prevent and medically manage patients, families and communities regarding high cholesterol. While counseling on cardiovascular risk, healthy lifestyle changes, and medications, they additionally face the challenges of caring for multicultural patients who speak various languages, have wide ranging socioeconomic status and unique ways of understanding illness and healthcare.

The 2013 ACC/AHA guidelines on lipids offer a perspective on lipid management using a more rigorous approach, based on RCT evidence, than in years past. The informed practitioner will be aware of past and present practices, the evidence they are based on, and acknowledge that some uncertainty and disagreement (among physicians, societies, and researchers) about management of cholesterol will remain for the time being.