Is your cholesterol too high based on latest guidelines? - Harvard Gazette

What the report says

Harvard Gazette reports that a Mass General Brigham research team found large gaps between current LDL cholesterol levels in U.S. adults and targets in the newly released 2026 American College of Cardiology/American Heart Association cholesterol guidelines. The study, published in JAMA, examined adults ages 30 to 79 using 2021-2023 National Health and Nutrition Examination Survey data, representing about 178 million U.S. adults.

According to the report, nearly one-third of adults without prior heart disease had LDL, commonly called “bad” cholesterol, above the new recommended goals. Among that group, about 76% were not taking cholesterol-lowering medication. The findings were more pronounced among people at the highest risk, with about 83% above target and roughly half not receiving medication.

For adults who had already experienced a heart attack, stroke or another cardiovascular event, the pattern differed. Nearly four in five were above the recommended LDL goal, but many were already on treatment: Harvard Gazette reported that about 62% were receiving cholesterol-lowering therapy yet had not reached the lower targets, while 38% were not receiving such treatment. Lead author Shady Abohashem of Harvard Medical School and Massachusetts General Hospital said the results point to different needs: starting therapy for many people without known heart disease and intensifying treatment for many with established disease.

The updated guidelines use a new cardiovascular risk calculator and set lower LDL goals for higher-risk patients, including a target below 55 mg/dL for those with established heart disease and very high future risk. Because the survey data predate the 2026 guideline release, the authors describe the results as a baseline for measuring whether care improves as clinicians adopt the new targets.