Guidelines Oriented Approach to Lipid Lowering (GOAL) in Canada

Inclusion Criteria: 1\. Adults ≥ 18 years old 2. High risk for cardiovascular morbidity and mortality (at least one of the following): 1. Clinical vascular disease: * Coronary Artery Disease (CAD): history of myocardial infarction (MI), Coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), angiographic disease * Cerebrovascular Disease (CeVD): history of cerebrovascular accident (CVA) or transient ischemic attack (TIA), carotid surgery * Abdominal Aortic Aneurism (AAA): history of surgery/intervention * Peripheral Arterial Disease (PAD): history of surgery/intervention 2. Familial hypercholesterolemia defined as LDL-C \> 5 mmol/L and one of: * typical physical findings (stigmata) such as tendon xanthomata, xanthelasma, and arcus corneae * personal history of early cardiovascular disease * family history of early cardiovascular disease or of marked hyperlipidemia 3. Receiving current optimal (maximal or maximal tolerated) statin therapy for at least 3 months prior to patient enrolment 4. LDL-C \> 2.0 mmol/L measured within 6 months of patient enrolment date and while on (despite) maximal tolerated statin therapy (± other lipid modifying therapies). 5. Desire and ability to execute the consent to participate. Exclusion criteria: 1. Current treatment with PCSK9 inhibitor 2. Participation in an investigational study 3. Prior participation in the GOAL program