A recent change in the paradigm of lipids management relates to the use of low-density-lipoprotein cholesterol (LDL-C) goals to direct the dose and type of statin prescribed. In place of LDL-C goals, the intensity of statin therapy (based on the ability of a particular dose of a drug to lower LDL-C) is now recommended by the American College of Cardiology and the American Heart Association to be calibrated to the level of cardiovascular risk. The role of niacin and fenofibrate has largely declined, although an emerging role for fenofibrate in the treatment and prevention of microvascular complications in patients with diabetes mellitus is emerging and presents interesting potential to extend the benefits of this class of drugs. Finally, the benefits of lipid lowering in patients with chronic kidney disease has now been demonstrated in randomised controlled trials and could probably be represented in the algorithms for risk stratification in future.