Cholesterol guidelines now stress earlier screening and clearer LDL targets.

On March 13, the American College of Cardiology and American Heart Association released updated 2026 cholesterol guidelines that expand risk assessment to adults starting in their 30s and restore specific LDL targets while recommending one-time Lp(a) testing.

On March 13, the American College of Cardiology and American Heart Association released updated cholesterol guidelines. The 2026 guidance emphasizes earlier and more personalized prevention. It expands formal risk assessment to adults ages 30 to 79 and highlights lifetime (30-year) risk as well as short-term risk. The update also restores specific LDL cholesterol targets and recommends one-time testing for lipoprotein(a), or Lp(a). Key points: - The guidelines expand risk assessment to adults ages 30–79, lowering the typical starting age from 40 in prior recommendations. - The update places more focus on lifetime prevention by incorporating 30-year risk alongside 10-year risk estimates. - Specific LDL cholesterol goals are reinstated: under 100 mg/dL for low risk, under 70 mg/dL for higher risk, and under 55 mg/dL for very high risk. - The guidelines highlight one-time Lp(a) testing in adulthood to identify an inherited marker of cardiovascular risk. Summary: The update shifts emphasis toward earlier identification of risk and clearer numerical LDL goals, which could influence screening and treatment patterns in clinical care. Restored LDL targets and attention to Lp(a) aim to uncover inherited or early risks that were less emphasized previously. How broadly and how quickly clinicians adopt the recommendations is undetermined at this time.