How can I organize my low-density lipoprotein (LDL) cholesterol management information to discuss with my cardiologist and pulmonologist?

Organizing Your LDL Cholesterol Information for Specialist Consultations

Create a structured document that includes your current lipid values, medication history, cardiovascular risk factors, and treatment goals to facilitate productive discussions with your cardiologist and pulmonologist.

Essential Information to Document

Current Lipid Profile Values

• Record your most recent LDL cholesterol level (measured in mg/dL), along with the date of testing 1
• Include total cholesterol, HDL cholesterol, and triglyceride levels from the same test 1
• Note whether the test was fasting or non-fasting 1
• If you have multiple recent tests, document the trend over time 2

Cardiovascular Risk Status

Document whether you have any of the following conditions, as these determine your treatment intensity 1:

• Clinical ASCVD (history of heart attack, stroke, coronary revascularization, peripheral artery disease) 1
• Diabetes mellitus and whether you require insulin or oral medications 1
• Hypertension with recent blood pressure readings 1
• Family history of premature coronary artery disease (male relatives <55 years, female relatives <65 years) 1
• Current or former tobacco use 1
• Chronic kidney disease with estimated glomerular filtration rate if available 1

Current Medication List

Create a comprehensive list including 1:

• Statin therapy: specific drug name, dose, and frequency (e.g., atorvastatin 40 mg daily) 1
• Other lipid-lowering medications: ezetimibe, PCSK9 inhibitors, bile acid sequestrants, fibrates 1
• All other medications including those for blood pressure, diabetes, and any supplements 3
• Note any medications you've tried previously and stopped, with reasons (side effects, cost, etc.) 1, 4

Treatment Response Documentation

Track your response to therapy 2, 4:

• Baseline LDL-C before starting treatment
• Current LDL-C on your present regimen
• Percentage reduction achieved (calculate: [(baseline - current)/baseline] × 100)
• Any side effects experienced, particularly muscle pain, weakness, or liver enzyme elevations 3

Treatment Goals Based on Your Risk Category

If You Have Clinical ASCVD

Your target LDL-C should be <70 mg/dL 1, 4

• If you have "very high-risk" features (multiple major ASCVD events, diabetes plus other risk factors, or recent acute coronary syndrome), this <70 mg/dL goal is particularly important 1, 4
• Document whether you're on maximally tolerated statin therapy 1
• Note if you're achieving <50% LDL-C reduction from baseline, as this may indicate need for intensification 1

If You Have LDL-C ≥190 mg/dL

This indicates possible familial hypercholesterolemia 1:

• Document any family members with similar cholesterol levels or premature heart disease 1
• Note if genetic testing has been performed 1
• Your treatment should include high-intensity statin therapy, potentially with additional agents 1

If You Have Diabetes (Ages 40-75)

Your treatment should include at least moderate-intensity statin therapy 1, 4:

• If your 10-year ASCVD risk is ≥7.5%, high-intensity statin is recommended 1
• Document your diabetes control (HbA1c if available) 1

Organizing Your Document

Create a One-Page Summary

Structure it as follows:

Section 1: Patient Demographics

• Age, sex, occupation status 5

Section 2: Cardiovascular Risk Factors (use checkboxes)

• List all applicable conditions from above 1

Section 3: Lipid Values Table Create a table with columns for: Date | Total Cholesterol | LDL-C | HDL-C | Triglycerides 1, 2

Section 4: Current Medications

• List with doses and frequencies 1
• Note adherence issues or side effects 4, 6

Section 5: Treatment Goals

• State your target LDL-C based on risk category 1
• Calculate gap between current and goal LDL-C 1

Section 6: Questions for Specialists Prepare specific questions such as 1, 4:

• "My current LDL-C is [X] mg/dL on [current regimen]. Should we add ezetimibe or a PCSK9 inhibitor to reach my goal of <70 mg/dL?"
• "What percentage additional LDL-C lowering do I need, and which medication would best achieve this?"
• "Are there any drug interactions between my current medications that we should address?"

Practical Considerations

Medication Access and Adherence

Document factors that may affect treatment 4, 6:

• Insurance coverage for medications, particularly PCSK9 inhibitors which may require prior authorization 6
• Cost concerns that might affect adherence 1, 4
• Administration preferences (oral vs. injectable medications) 1, 6
• Pill burden and whether simplification would improve adherence 4, 6

Follow-Up Planning

Note when your next lipid panel is scheduled 2:

• LDL-C should be rechecked as early as 4 weeks after starting or intensifying therapy 3
• Plan for regular monitoring every 3-6 months once stable 2

Storage and Sharing

• Keep electronic and paper copies of this document 2
• Update before each appointment with new lab values or medication changes 2
• Share with both specialists to ensure coordinated care 5
• Consider using a patient portal if your healthcare system offers one for easy access by all providers 6

This structured approach ensures both specialists have complete information to make evidence-based recommendations for optimizing your cardiovascular risk reduction 4, 5.