2026 cholesterol guidelines: Why 1 in 3 adults are above safe limits - Medical News Today

What the report says

Medical News Today reports that the 2026 American College of Cardiology/American Heart Association dyslipidemia guideline marks a notable shift in cholesterol care, with new emphasis on individualized cardiovascular risk, lower LDL cholesterol goals for some patients, expanded screening and additional tests. The article says the update replaces the 2018 blood cholesterol guideline and brings back specific LDL-C targets while advising clinicians to consider broader risk factors rather than relying on LDL alone.

According to the report, Mass General Brigham researchers recently found that about one-third of U.S. adults without known heart disease have LDL levels above the new guideline’s recommended goals. Among people who have already experienced a cardiovascular event such as a heart attack or stroke, the share rises to nearly four in five. The guideline’s cited targets include LDL under 55 mg/dL for very high-risk patients, and under 70 mg/dL or 100 mg/dL depending on baseline risk in other groups.

Medical News Today interviewed Chandan K. Buttar, Wahaj Aman and Kyle Hoedebecke, who highlighted several changes: use of the PREVENT risk calculator, screening from childhood at ages 9–11 and again at 19–21, adult follow-up every five years, once-in-a-lifetime lipoprotein(a) testing for adults, and calcium score testing in selected intermediate-risk patients. The experts said family history, chronic kidney disease, inflammatory conditions and elevated Lp(a) may affect treatment decisions.

The article also notes barriers to treatment, including lack of symptoms, limited access to preventive care, concerns about statin side effects and disparities in who is offered statins. Experts said patients with muscle symptoms may be evaluated for other causes or considered for lower-dose statins, alternate statins, ezetimibe, bempedoic acid, PCSK9 inhibitors or inclisiran.