Your situation (severe hypercholesterolemia short-circuits the risk score) LDL-C ≥190 mg/dL
ldl-190No one has reached this rule yetHigh-intensity statin now, regardless of calculated risk (severe hypercholesterolemia)
No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.
Word for word, as generated for the example person below. Figures in the text are theirs.
High-intensity statin therapy now, regardless of your calculated risk score.
Your LDL-C (212 mg/dL) is at or above 190 — "severe hypercholesterolemia," often inherited (familial hypercholesterolemia). The guideline treats this as an independent reason to start a high-intensity statin without running a risk calculation, aiming for at least a 50% LDL-C reduction. Ask your doctor whether ezetimibe or a PCSK9 inhibitor should be added, and whether first-degree relatives should be screened.
Guideline consensusRecommended by the guideline writing committee, drawing on trials plus expert judgement where trials run out.· Class I· checked 2026-09-12
2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Class I
“Very high LDL” — an illustrative profile, not a real user.
Asked after: No known cardiovascular disease
Cited by the recommendations above.
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Runs in lib/engine/lipidPathway.ts as ldl-190.