A 43-year-old white man was diagnosed with hyper- lipidemia at age 13 years, when his father died of a myocardial infarction at age 34 years. The man's grandfather had died at age 43 years, also of a myo- cardial infarction. Currently, the man is active and asymptomatic with regard to CHD. He is taking 40 r of lovastatin (Mevacor), 2 times/d (maximum dose). He had previously taken niacin but could not toler- ate it because of flushing and gastrointestinal distress, nor could he tolerate cholestyramine resin (Questran). His physical examination is remarkable for bilateral Achilles tendon thickening/xanthomas and a right carotid bruit (Case Study Table 15-3.1). CASE STUDY TABLE 15-3.1 LABORATORY RESULTS Triglycerides Total cholesterol HDL-C LDL-C Aspartate aminotransferase Alanine aminotransferase Alkaline phosphatase Electrolytes and fasting glucose 91 mg/dL 269 mg/dL 47 mg/dL 204 mg/dL 34 U/L 36 U/L 53 U/L Normal mg Questions 1. What is his diagnosis? 2. Does he need further workup? 3. What other laboratory tests should be done? 4. Does he need further drug treatment? If so, w what?