What are your diagnostic and management approaches beyond statin therapy for hyperlipidemia in young adults with significantly elevated LDL levels in isolation (i.e. reasonable calcium score, normal lipoprotein A levels)?

It depends on other factors such as the presence of diabetes and a family history of early CAD. If either of these is present, I push hard with statins and possibly add Zetia to get the LDL down to 60-70. I also push for lifestyle changes such as moderate daily exercise, weight loss, and reducing li...