New Cholesterol Guideline Emphasizes Earlier Screening, Personalized Risk Assessments

The updated recommendations from the American College of Cardiology and American Heart Association aim to lower heart disease risk through proactive prevention strategies.

Mar. 28, 2026 at 5:04am

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The American College of Cardiology and American Heart Association have released new guidelines for screening and managing blood cholesterol levels, with a focus on earlier screenings, especially for those with a family history of heart disease, and more personalized risk estimations to support shared decision-making between clinicians and patients.

Why it matters

The updated guideline comes as studies show that 1 in 4 U.S. adults have elevated LDL cholesterol, a major risk factor for atherosclerosis and heart disease. The new recommendations emphasize the importance of foundational lifestyle interventions as well as more targeted use of medications to lower cholesterol and reduce cardiovascular disease risk.

The details

Key changes in the new guideline include recommending earlier screening for those with familial hypercholesterolemia, one-time screening for lipoprotein(a) levels, and using a new risk calculator called PREVENT that incorporates additional data like blood sugar and kidney health to estimate 10- and 30-year risks for heart attacks and strokes. The guideline also provides recommendations for managing cholesterol in special populations like pregnant women, older adults, and those with underlying conditions.

  • The new guideline was jointly published on March 28, 2026 in the Journal of the American College of Cardiology and Circulation.
  • The guideline will be discussed at the American College of Cardiology's 75th Annual Scientific Session in New Orleans on March 28, 2026.

The players

Roger S. Blumenthal, M.D.

Chair of the guideline writing committee and director of the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease.

Seth Martin, M.D., M.H.S.

Cardiologist, member of the guideline writing committee, and director of the Advanced Lipid Disorders Program and Digital Health Lab at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease.

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What they’re saying

“We know that lower LDL cholesterol levels are better when it comes to reducing the risk of heart attacks, strokes and congestive heart failure.”

— Roger S. Blumenthal, Chair of the guideline writing committee

“Shifting the paradigm toward proactive prevention strategies earlier in life can meaningfully change the trajectory of cardiovascular disease and lead to better health outcomes for people decades later.”

— Seth Martin, Cardiologist, member of the guideline writing committee

What’s next

The updated guideline provides details about statin therapy and other lipid-lowering treatments, with recommendations for optimal LDL-C levels based on a person's cardiovascular disease risk. Future guidelines may likely recommend even lower LDL-C targets for those with moderate or higher atherosclerosis risk.

The takeaway

The new cholesterol screening and management guideline emphasizes the importance of proactive, personalized prevention strategies to reduce the burden of heart disease, including earlier risk assessments, targeted use of medications, and a continued focus on foundational lifestyle interventions.