Top 10 messages of new 2026 dyslipidemia guideline
18/03/2026
The 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of dyslipidemia contains updated and new recommendations for the management of individuals with dyslipidemia, including high blood cholesterol, hypertriglyceridemia, and elevated Lp(a).
The authors of the guidelines have summarized the content in 10 take-home messages:
- Treat dyslipidemia earlier to reduce lifelong exposure to atherogenic lipoproteins, with early lifestyle intervention in youth and consideration of pharmacotherapy in high-risk youth and young adults.
- Use PREVENT™ equations (not PCE) for 10- and 30-year risk assessment and apply the CPR model: Calculate, Personalize, Reclassify and Reassess.
- LDL-lowering therapy in primary prevention can be considered at 10-year PREVENT-ASCVD risk estimate of 3%–<5%, and should be considered at ≥5%–<10% risk after clinician–patient discussion.
- LDL-c and non–HDL-c targets are reinstated to guide lipid-lowering therapy.
- ApoB measurement can improve risk assessment and guide therapy, especially in patients with high triglycerides, diabetes, or low achieved LDL-c.
- Lp(a) should be measured at least once, with elevated levels prompting intensified risk factor management.
- CAC scoring in men of ≥40 years old and women of ≥45 years old can improve risk stratification and help guide treatment goals.
- In primary prevention, LDL-lowering therapy is recommended regardless of LDL-c in adults (ages 40–75) with diabetes, CKD, or HIV. In adults of >75 years old, LDL-lowering therapy can be considered in conjunction with lifestyle interventions to reduce ASCVD risk.
- In secondary prevention, treatment goals of LDL-c <55 mg/dL (1.4 mmol/L) and non–HDL-c <85 mg/dL (2.2 mmol/L) are recommended in patients at very high risk of ASCVD events.
- For patients with elevated triglycerides, statins remain the foundational therapy to reduce ASCVD risk, with additional TG-lowering therapies for pancreatitis risk reduction.