I. B. A. Menown () Craigavon Cardiac Centre, Craigavon BT63 5QQ, Northern Ireland, UK. Email: ian.menown@southerntrust.hscni.net G. Murtagh · V. Maher · M. T. Cooney · I. M. Graham Adelaide, Meath and National Children’s Hospital (AMNCH), Tallaght, Dublin 24, Ireland G. Tomkin Diabetes Institute of Ireland, Beacon Clinic, Sandyford, Dublin 18, Ireland Adv Ther (2009) 26(7):711-718. DOI 10.1007/s12325-009-0052-3 REVIEW Dyslipidemia Therapy Update: the Importance of Full Lipid Profile Assessment I. B. A. Menown · G. Murtagh · V. Maher · M. T. Cooney · I. M. Graham · G. Tomkin Received: June 6, 2009 / Published online: July 27, 2009 / Printed: July 29, 2009 © Springer Healthcare Communications 2009 ABSTRACT Lipid guidelines typically focus on total choles- terol ± low-density lipoprotein cholesterol levels with less emphasis on high-density lipoprotein cholesterol (HDL-C) or triglyceride assessment, thus potentially underestimating cardiovascular (CV) risk and the need for lifestyle or treatment optimization. In this article, we highlight how reliance on isolated total cholesterol assessment may miss prognostically relevant lipid abnormal- ities; we describe from the European Systematic COronary Risk Evaluation (SCORE) data set how incorporation of HDL-C may improve estima- tion of CV risk; and, inally, we critically evalu- ate the evidence base surrounding triglycerides and CV risk. Keywords: cardiovascular risk; cholesterol; dyslipidemia; high-density lipoprotein choles- terol; triglycerides INTRODUCTION For the treatment of patients with, or at risk of, cardiovascular (CV) disease, some guidelines focus primarily on total cholesterol ± low-density lipoprotein cholesterol (LDL-C) levels. However, this can lead clinicians to disregard, or even fail to measure, high-density lipoprotein cholesterol (HDL-C) and triglycerides (TGs), thus poten- tially underestimating CV risk and the need for lifestyle or treatment optimization. European guidelines recommend measurement of HDL-C and TGs (although not formal treatment goals) in patients at intermediate or high risk, 1 and the North American National Cholesterol Education Program (NCEP ATP III) identiies non-HDL-C as a secondary target for treatment. 2 A practical example of how knowledge of HDL-C and TG levels may be used to guide lipid treatment is shown in Figure 1. This guide, which was based largely on the Joint British Societies (JBS)-2 rec- ommendations for primary and secondary pre- vention, 3 additionally suggests consideration of speciic HDL-C and TG targets (as agreed by