2026 ACC/AHA Dyslipidemia Guidelines
Screening
Who
-At 19 yo, and every 5y
-At 9–11, 1x s/f FH
≥2y, if FH⊕
How
-Lipid profile (TC, LDL, HDL, TG)
-ApoB
>For high-risk group already in LLT
-Lpa
>At least 1x in life
>FH hx
Follow-up
-Draw lab, repeat 3 mo, repeat every year
CPR Framework
Calculate risk→ Personalize→ Reclassify
Calculate risk
PREVENT-ASCVD
https://professional.heart.org/en/guidelines-and-statements/prevent-calculator
-Age 30–79
-Results: low < 3%, border 3–5, intermediate 5-10, high ≥10
Personalize
-Assess risk enhancers
Reclassify
CAC, coronary artery calcium
Management→ Absolute Goals!
-Primary prevention
*Automatic LLT, regardless of LDL-C level
Adults aged 40-75 with diabetes, chronic kidney disease (stage 3 or 4), or HIV!
Goals
ApoB
Lpa
-Goal < 75
-Statins do no ↓ Lpa, only PCSK9
PCSK9 and Bempedoic acid
non-HDL-C?
