Dyslipidaemia: Pathophysiology, Epidemiology, Diagnostic Advances, and Emerging Therapeutic Strategies

Abstract Dyslipidaemia, characterized by aberrant circulating lipid and lipoprotein profiles, remains a primary driver of atherogenesis and cardiovascular disease (CVD), underlying substantial global morbidity and mortality. This review elucidates the complex pathophysiology, epidemiological dynamics, and genetic architectures defining dyslipidaemia, delineating primary hereditary molecular defects from secondary acquired etiologies. We highlight recent paradigms in molecular biology, advanced lipid biomarkers surpassing conventional lipid panels, and innovative imaging modalities that have collectively refined cardiovascular risk stratification and diagnostic precision. Furthermore, this work addresses the socioeconomic determinants and lifestyle factors that modulate prevalence and confound clinical management. Current therapeutic regimens—ranging from behavioral modifications and established pharmacological agents (statins, ezetimibe, and PCSK9 inhibitors) to emerging RNA-targeted therapeutics—are critically evaluated. We discuss persistent barriers to patient adherence and the transformative potential of precision medicine, driven by clinical genomics and targeted molecular interventions. Finally, we outline prospective paradigms integrating multi-omics frameworks, novel diagnostics, and psychosocial variables to mitigate the global burden of dyslipidaemia-mediated cardiovascular pathologies.