A lipid panel is used (1) to identify patients with familial hyperlipidemia, (2) as a baseline to monitor statin efficacy (e.g., in secondary prevention patients), (3) as part of shared decision-making regarding initiation of statin therapy in primary prevention patients 40 to 75 years of age, (4) to estimate lifetime ASCVD risk in patients 20 to 39 years of age.
Screening is recommended in patients two years of age or older if family history suggests early ASCVD or significant primary hypercholesterolemia. Identification of severe hypercholesterolemia should prompt screening of additional family members.
Some data suggests routine screening of children ≥10 years of age, but this is controversial.
Consider screening patients with a chronic inflammatory disease or HIV. In rheumatoid arthritis, it can be useful to reassess lipids and other major risk factors two to four months after disease has been brought under control.