Recognition that a physician-directed case management system utilizing a certified registered nurse practitioner (CRNP) and computer-based decision support technology (CDST) offers the potential to implement disease management guidelines consistently and effectively is the impetus for this project. This project will demonstrate that enhanced compliance with the National Cholesterol Education Program (NCEP) guidelines can be achieved in a randomized trial conducted in subjects enrolled in a general medical clinic. The way in which hyperlipidemia will be managed is determined by randomization of the PCP providers to either the usual care group or to the intervention group, in which the management of subjects is delegated to the CRNP in conjunction with the CDST, under the supervision of the physician- investigators. Approximately 220 hypercholesterolemic subjects who are eligible for risk reduction according to NCEP guidelines will be recruited in equal numbers from subjects enrolled in the primary care clinic, beginning in 2005.