The 2012 Canadian Cardiovascular Society (CCS) Dyslipidemia Guidelines have been updated to reflect new clinical trial and epidemiologic evidence. The primary panel posed a number of PICO (population, intervention, comparator, outcomes) questions to create recommendations based on detailed literature review. The PICO format is a common standard used for guidelines implementation, aiding clinicians in determining if the recommendations apply to their own patients with outcomes relevant to their practice. Using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) standards, individual studies and composite literature was reviewed for quality and bias. We have included both strong and conditional recommendations within the main manuscript. The literature review and results of voting on each PICO question are included in the Supplement. For recommendations to go forward a 2/3 voting majority was required. Individuals with conflicts of interest were recused from voting. We have introduced a recommendation for non-fasting lipid determination and retained the concept of LDL-C targets of treatment. Global risk assessment is discussed recognizing there are several approaches in a primary prevention setting. The overall goal of the process was to produce a document based on the best available evidence that would allow clinicians and patients to make collaborative treatment decisions (Table 1). These guidelines are not absolute, but are meant to launch one on one discussion between practitioner and patient. As dyslipidemia is an important risk factor for cardiovascular disease, these guidelines will allow appropriate risk assessment, treatment and surveillance options of our at risk population. These guidelines were undertaken under the auspices of the Guideline Committee of the CCS without any support or involvement from outside groups including industry.

CVD events: cardiovascular death, non-fatal myocardial infarction, ischemic stroke, revascularization, acute coronary syndromes hospitalizations

NNT: number needed to treat to prevent one CVD event for 5 years of treatment per 1 mmol/L reduction in LDL-C. NNT of <50 are generally regarded as desirable by physicians with some patients wishing to see NNT<30 to deem an intervention as acceptable.