DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS The ACC and AHA released updated dyslipidemia management guidelines on March 13, 2026, published in the Journal of the American College of Cardiology. The guidelines reintroduce specific LDL-C targets, mandate earlier lifestyle intervention, and introduce the PREVENT risk calculator as the new standard for ASCVD risk estimation.
Clinical Considerations
- LDL-C targets are now tiered: less than 100 mg/dL for borderline/intermediate risk, less than 70 mg/dL for high risk, and less than 55 mg/dL for very high-risk secondary prevention patients.
- The PREVENT calculator replaces prior risk tools for guiding lipid-lowering therapy decisions in primary prevention.
- Lipoprotein(a) and apolipoprotein B measurement is now formally recommended for select high-risk populations, including those with CKD, diabetes, and established CVD.
- CAC scanning is selectively recommended for men 40-plus and women 45-plus with borderline or intermediate 10-year MI/stroke risk.
Practice Applications
- Adopt the PREVENT calculator immediately for all primary prevention lipid-lowering therapy decisions.
- Add PCSK9 inhibitors, ezetimibe, or bempedoic acid when statin therapy alone fails to reach LDL-C goals.
- Screen all children aged 9 to 11 years for cholesterol if not previously tested.
- Measure lipoprotein(a) in patients with CKD, diabetes, high triglycerides, or known cardiovascular disease at LDL-C goal.
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