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| Class I |
| a. LDL-C should be <100 mg/dL. (Level of Evidence: A) |
| b. If baseline LDL-C is ≥100 mg/dL, initiate LDL-lowering drug therapy. (Level of Evidence: A) |
| c. If on-treatment LDL-C is ≥100 mg/dL, intensify LDL-lowering drug therapy (may require LDL-lowering drug combination). (Level of Evidence: A) |
| d. If triglycerides are 200 to 499 mg/dL, non-HDL-C should be <130 mg/dL. (Level of Evidence:B) |
| e. Therapeutic options to reduce non HDL - C are more intense LDL - C lowering therapy. (Level of Evidence:B) |
| f. If triglycerides are ≥500 mg/dL, therapeutic options to prevent pancreatitis are fibrate or niacin before LDL-lowering therapy; and treat LDL-C to goal after triglyceride-lowering therapy. Achieve non-HDL-C <130 mg/dL if possible. (Level of Evidence:C) |
| Class IIa |
| a. Reduction of LDL-C to <70 mg/dL is reasonable. (Level of Evidence:A) |
| b. If baseline LDL-C is 70 to 100 mg/dL, it is reasonable to treat to LDL-C <70 mg/dL. (Level of Evidence:B) |
| c. If triglycerides are 200 to 499 mg/dL, reduction of non-HDL-C to <100 mg/dL is reasonable. (Level of Evidence:B) |
| d. Therapeutic options to reduce non HDL - C are Niacin (after LDL-C loweing therapy). (Level of Evidence:B) |
| e. Therapeutic options to reduce non HDL - C are Fibrate therapy (after LDL-C loweing therapy). (Level of Evidence:B) |
| Class I |
| a. LDL-C should be <100 mg/dL. (Level of Evidence: A) |
| b. If baseline LDL-C is ≥100 mg/dL, initiate LDL-lowering drug therapy. (Level of Evidence: A) |
| c. If on-treatment LDL-C is ≥100 mg/dL, intensify LDL-lowering drug therapy (may require LDL-lowering drug combination). (Level of Evidence: A) |
| d. If triglycerides are 200 to 499 mg/dL, non-HDL-C should be <130 mg/dL. (Level of Evidence:B) |
| e. Therapeutic options to reduce non HDL - C are more intense LDL - C lowering therapy. (Level of Evidence:B) |
| f. If triglycerides are ≥500 mg/dL, therapeutic options to prevent pancreatitis are fibrate or niacin before LDL-lowering therapy; and treat LDL-C to goal after triglyceride-lowering therapy. Achieve non-HDL-C <130 mg/dL if possible. (Level of Evidence:C) |
| Class IIa |
| a. Reduction of LDL-C to <70 mg/dL is reasonable. (Level of Evidence:A) |
| b. If baseline LDL-C is 70 to 100 mg/dL, it is reasonable to treat to LDL-C <70 mg/dL. (Level of Evidence:B) |
| c. If triglycerides are 200 to 499 mg/dL, reduction of non-HDL-C to <100 mg/dL is reasonable. (Level of Evidence:B) |
| d. Therapeutic options to reduce non HDL - C are Niacin (after LDL-C loweing therapy). (Level of Evidence:B) |
| e. Therapeutic options to reduce non HDL - C are Fibrate therapy (after LDL-C loweing therapy). (Level of Evidence:B) |
| Class III (No Benefit) |
| 1. Genetic testing is not indicated in relatives when the index patient does not have a definitive pathogenic mutation. (Level of Evidence: B) |
| 2. Ongoing clinical screening is not indicated in genotype-negative relatives in families with HOCM. (Level of Evidence: B) |