2026 Guideline on the Management of Dyslipidemia The American Heart Association has released updated recommendations for managing dyslipidemia, emphasizing a more comprehensive approach to assessing and treating lipid disorders. Key updates include the integration of the PREVENT-ASCVD equations to guide primary-prevention lipid-lowering therapy, which helps clinicians determine individualized risk levels for atherosclerotic cardiovascular disease (ASCVD). The guideline also recommends testing for lipoprotein(a) [Lp(a)] at least once in a lifetime and selective measurement of apolipoprotein B (ApoB) to enhance risk assessment and treatment decisions. Previously retired LDL-C and non-high-density lipoprotein cholesterol (non-HDL-C) treatment goals are now reintroduced, with lower targets set for higher-risk patient groups. Additionally, the expanded use of coronary artery calcium (CAC) scoring is highlighted as a tool to reclassify risk and improve stratification. These changes reflect a broader understanding of ASCVD risk factors beyond low-density lipoprotein cholesterol (LDL-C), incorporating triglyceride-rich remnant particles and Lp(a) into clinical evaluation. The guideline replaces the 2018 AHA/ACC Guideline on the Management of Blood Cholesterol, now titled the 2026 Guideline on the Management of Dyslipidemia. This shift underscores the evolving recognition of atherogenic lipoproteins, including Lp(a), in contributing to cardiovascular disease. The updated recommendations are based on clinical evidence through late 2024, addressing the evaluation, management, and monitoring of individuals with high blood cholesterol, hypertriglyceridemia, and elevated Lp(a). Writing Committee Chairs Roger S. Blumenthal, MD, and Pamela B.#american_heart_association #prevent_ascvd #lipoprotein_a #apob #cac_scoring
