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New 2026 Cholesterol Treatment Guidelines

One of the most important changes is conceptual. The document is no longer called a blood cholesterol guideline. It is now a guideline on the management of dyslipidemia. That matters because it recognizes that cardiovascular risk does not come only from LDL. Triglyceride-rich particles, remnant particles, and Lp(a) also matter. The guideline also folds in newer medicines and newer risk tools that were not part of the 2018 version. In plain English, the new message is this: Your doctor should not look only at one cholesterol number. They should look at your whole risk picture.

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 ACC/American Heart Association Issue Updated Guideline for Managing Lipids, Cholesterol

Healthy lifestyle habits, earlier treatment to lower long-term exposure to plaque-causing lipids, new cholesterol target goals, selective use of coronary calcium scoring, lipoprotein(a) and apolipoprotein B testing, new treatments, and guidance for managing lipids in specific populations among key focus areas

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2026 Dyslipidemia Guideline-at-a-Glance

The 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia 1 (ACC/AHA/Multisociety Dyslipidemia Guideline) focuses on the implementation of new therapies and the evaluation of associated risk for individuals with dyslipidemia in primary and secondary prevention settings. The guideline advances a new approach to risk assessment through a novel risk score, sets lower low-density lipoprotein cholesterol (LDL-C) and non–high-density lipoprotein cholesterol (HDL-C) treatment goals for patients with established atherosclerotic cardiovascular disease (ASCVD), and recommends measuring lipoprotein(a) [Lp(a)] at least once to identify individuals at higher risk of ASCVD.

Cholesterol Guidelines Are Changing: Here’s What’s New

For years, caring for your heart has focused on low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, and that hasn’t changed. The new guidelines recommend earlier treatment and more proactive prevention, including a one-time lipoprotein(a) testing for all adults. It’s a simple blood draw, and it can be ordered by a primary care doctor.

Guidelines for the Management of Dyslipidemia

Apolipoprotein B (Apo B) can be useful to improve risk assessment and guide therapy once LDL-C and non–HDL-C goals are met, particularly in those with elevated triglycerides (TG) (>200 mg/dL), diabetes, or low LDL-C levels (<70 mg/dL). 6. Lipoprotein(a) [Lp(a)] should be measured at least once to identify individuals at increased risk of ASCVD. Levels >125 nmol/L (>50 mg/dL) are associated with an approximately 1.4-fold increased ASCVD risk and values >250 nmol/L (>100 mg/dL) are associated with >2-fold higher risk. An elevated Lp(a) is an indication for more intensified LDL-C lowering and management of other risk factors.

New cholesterol guidelines: 5 takeaways from a UChicago Medicine cardiologist who helped write them

The guidelines recommend all adults get a one-time blood test to measure lipoprotein(a) — or Lp(a) — a cholesterol-carrying particle found in the blood. This test is especially important if you have a first-degree relative with elevated Lp(a). An Lp(a) level above 125 nmol/L indicates higher cardiovascular risk. High Lp(a) levels increase heart risk by promoting inflammation and can lead to clots in the coronary arteries, causing a heart attack. Unlike LDL, you can’t change Lp(a) with diet or exercise. If elevated Lp(a) is detected, a person should have a thorough evaluation of their cardiovascular risk factors — including blood pressure, glucose and lifestyle. Depending on the Lp(a) level and other risk factors, cholesterol-lowering medication may be needed.

New Lipid Guidelines Redefine Risk Categories, Loop in People as Young as 30

Meanwhile, biomarker assessments outside LDL and HDL cholesterol are newly encouraged to help gauge ASCVD risk in the new guideline. Lipoprotein(a) should be measured at least once in all adults (class I) Noncontrast coronary artery calcium (CAC) scans should be performed if the decision to initiate lipid-lowering therapy is uncertain for adults at intermediate risk and select adults at borderline risk with no prior ASCVD (class I) Apolipoprotein B is a reasonable test to perform in people already on lipid-lowering therapy who may be candidates for further therapeutic intervention once LDL and non-HDL cholesterol goals are achieved (class IIa)

Top 10 Things to Know About the ACC/AHA Cholesterol Guideline

Apolipoprotein B or ApoB – Testing for ApoB can help when someone has high triglycerides, metabolic syndrome or type 2 diabetes. These conditions can increase the number of harmful cholesterol particles in the blood, even when LDL cholesterol looks normal. An ApoB test gives a clearer picture of heart disease risk.

US Cardiologists Issue New Guidelines For How to Manage Cholesterol

The new guidelines are still very much about managing cholesterol, but they also take a broader perspective, focusing on taking action earlier to address blood fats that can harm people's health.

What’s Different About the New Cholesterol Guidelines?

Cardiovascular disease remains a leading health concern in the United States, and it is becoming more common among younger people. In response, the American College of Cardiology, the American Heart Association, and nine other leading medical associations recently developed new guidelines for managing your cholesterol. The new guidelines recommend earlier testing and treatment, assessing risk more broadly, and achieving specific LDL levels—levels of the “bad cholesterol” known as low-density lipoprotein cholesterol.