New 2026 cholesterol guidelines push earlier, personalized treatment for heart disease risk

In March 2026 the American Heart Association and American College of Cardiology issued revised dyslipidemia guidelines that stress treating high cholesterol sooner and more aggressively. Beyond traditional LDL and HDL measurements, the new protocol recommends testing for lipoprotein A and apolipoprotein B, as well as coronary artery calcium scoring via CT. Clinicians are urged to use the PREVENT-ASCVD calculator, which weighs factors such as BMI, blood pressure, diabetes, kidney function and smoking status to assign a 10-year and 30-year cardiovascular risk.

Statins remain first-line therapy, but newer medication classes are suggested for patients who do not reach targets or cannot tolerate statins. The guidelines also call for cholesterol checks in children aged 9-11 and routine testing every five years for adults, alongside lifestyle recommendations like 150 minutes of moderate exercise weekly and modest weight loss for overweight individuals.