People 30 or older may now be recommended Lp(a) screening

The American Heart Association, the American College of Cardiology and other groups now recommend measuring lipoprotein(a), or Lp(a), at least once in adulthood, and they say cholesterol-lowering medication can be considered as early as age 30 when lifestyle changes do not bring LDL-C into target ranges.

Major U.S. heart organizations have issued updated guidance that changes timing for some cholesterol screening and treatment. The American Heart Association, the American College of Cardiology and nine other medical associations published the recommendations in JACC and Circulation on March 13. The guidance says healthy lifestyle measures and routine cholesterol screening should begin in childhood and adds that lipoprotein(a), or Lp(a), should be measured at least once in adulthood. It also states that medicinal LDL-C lowering can be considered as early as age 30 when diet and behavior changes do not achieve desirable lipid levels. Guideline highlights: - The guidance was jointly issued by the American Heart Association, the American College of Cardiology and nine other medical associations and was published March 13 in the journals JACC and Circulation. - Lipoprotein(a), or Lp(a), is recommended to be measured at least once in adulthood because it is a genetic marker linked to higher long-term risk of heart attack and stroke. - Routine healthy lifestyle intervention and average cholesterol screening are recommended to begin in childhood. - The guidelines recommend considering medicinal LDL-C lowering starting as young as 30 when lifestyle optimization does not bring lipid numbers into the desirable range; statins are described as the foundation of treatment and non-statin therapies are options if statins are inadequate. - Reported LDL-C target ranges in the guidance include under 100 mg/dL for people at borderline or intermediate risk and under 70 mg/dL for those at high risk. Summary: The guidance emphasizes a one-time Lp(a) measurement in adulthood and earlier consideration of LDL-C lowering medications when lifestyle measures fail to achieve target lipid levels. Undetermined at this time.