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
American Heart Association's New Cholesterol Guidelines Emphasise Earlier Screening, Lifetime Heart Risk Reduction The American Heart Association (AHA) and the American College of Cardiology (ACC) have released the 2026 Guideline on the Management of Dyslipidemia, marking the first major update to cholesterol guidelines since 2018. The new recommendations focus on dyslipidemias, including LDL cholesterol and triglycerides, and emphasize strategies to reduce lifetime cardiovascular risk through earlier screening and personalized treatment. The guidelines, published jointly in Circulation and the Journal of the American College of Cardiology, incorporate evidence up to late 2024 and aim to address the rising prevalence of heart disease in younger populations. Dr. Roger Blumenthal, chair of the guideline writing committee and director of the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, highlighted that 80% or more of cardiovascular disease is preventable. He noted that elevated LDL cholesterol, often called "bad" cholesterol, is a significant contributor to this risk. While lifestyle changes remain the first step in managing cholesterol, the guidelines recommend initiating lipid-lowering medication earlier than previously advised if lifestyle modifications fail to bring lipid levels into the desired range. Lowering LDL cholesterol over the long term, similar to managing blood pressure, provides greater protection against future heart attacks and strokes. The guidelines replace older risk assessment tools like the Pooled Cohort Equations, which overestimated the 10-year risk of heart attack and stroke by 40%-50%.#circulation #american_heart_association #american_college_of_cardiology #johns_hopkins_ciccarone_center #prevent_ascvd
